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Cytological diagnosis of Langerhans cell histiocytosis with cutaneous involvement.

Chandekar SA, Shah VB, Kavishwar V - J Cytol (2013)

Bottom Line: Diagnosis of LCH is often difficult and may be delayed because of its rarity and especially so if it occurs with unusual presentation.A high index of suspicion, awareness of characteristic cytological features of LCH and its differential diagnoses is necessary.This can obviate the need of biopsy and electron microscopy.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Topiwala National Medical College and B. Y. L. Nair Charitable Hospital, Mumbai, Maharashtra, India.

ABSTRACT
Langerhans cell histiocytosis (LCH) is a rare disease affecting predominantly children. The course of the disease varies, from spontaneous resolution to a progressive multisystem disorder with organ dysfunction and potential life-threatening complications. Diagnosis of LCH is often difficult and may be delayed because of its rarity and especially so if it occurs with unusual presentation. Fine needle aspiration cytology of a 4 year old male child, a case of LCH is presented with a purpose of highlighting the characteristic cytological features. A high index of suspicion, awareness of characteristic cytological features of LCH and its differential diagnoses is necessary. This can obviate the need of biopsy and electron microscopy. Immunohistochemistry if available can be performed on cytology smear and cell block.

No MeSH data available.


Related in: MedlinePlus

(a) Cellular smear showing loose clusters of cells with preponderance of histiocytes with few of them showing kidney shaped nucleus (arrow), alongwith neutrophils (N), lymphocytes (L) in the background. (Pap, ×400); (b) Cells showing pseudoinclusion (arrow) (Pap, ×400); (c) Binucleated histiocyte (arrow) (Giemsa, ×400)
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Figure 1: (a) Cellular smear showing loose clusters of cells with preponderance of histiocytes with few of them showing kidney shaped nucleus (arrow), alongwith neutrophils (N), lymphocytes (L) in the background. (Pap, ×400); (b) Cells showing pseudoinclusion (arrow) (Pap, ×400); (c) Binucleated histiocyte (arrow) (Giemsa, ×400)

Mentions: The patient was referred for FNAC. FNAC from diffused selling over left supraclavicular region yielded hemorrhagic whitish aspirate. Ethanol fixed smears and air dried smears were prepared and stained with Papanicolaou and Giemsa stains respectively. Cytological smears were cellular and showed numerous atypical histiocytes singly and in loose cohesive clusters. These histiocytes were binucleate, multinucleate with abundant dense cytoplasm and eccentric vesicular nuclei [Figure 1a-c]. The nuclei showed characteristic intranuclear pseudoinclusions, prominent nuclear indentations and grooves (with a kidney or coffee bean appearance) [Figure 1b]. The background showed lymphocytes, neutrophils and few eosinophils [Figure 1a]. The presumptive diagnosis of Langerhans cell histiocytosis was given.


Cytological diagnosis of Langerhans cell histiocytosis with cutaneous involvement.

Chandekar SA, Shah VB, Kavishwar V - J Cytol (2013)

(a) Cellular smear showing loose clusters of cells with preponderance of histiocytes with few of them showing kidney shaped nucleus (arrow), alongwith neutrophils (N), lymphocytes (L) in the background. (Pap, ×400); (b) Cells showing pseudoinclusion (arrow) (Pap, ×400); (c) Binucleated histiocyte (arrow) (Giemsa, ×400)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3643374&req=5

Figure 1: (a) Cellular smear showing loose clusters of cells with preponderance of histiocytes with few of them showing kidney shaped nucleus (arrow), alongwith neutrophils (N), lymphocytes (L) in the background. (Pap, ×400); (b) Cells showing pseudoinclusion (arrow) (Pap, ×400); (c) Binucleated histiocyte (arrow) (Giemsa, ×400)
Mentions: The patient was referred for FNAC. FNAC from diffused selling over left supraclavicular region yielded hemorrhagic whitish aspirate. Ethanol fixed smears and air dried smears were prepared and stained with Papanicolaou and Giemsa stains respectively. Cytological smears were cellular and showed numerous atypical histiocytes singly and in loose cohesive clusters. These histiocytes were binucleate, multinucleate with abundant dense cytoplasm and eccentric vesicular nuclei [Figure 1a-c]. The nuclei showed characteristic intranuclear pseudoinclusions, prominent nuclear indentations and grooves (with a kidney or coffee bean appearance) [Figure 1b]. The background showed lymphocytes, neutrophils and few eosinophils [Figure 1a]. The presumptive diagnosis of Langerhans cell histiocytosis was given.

Bottom Line: Diagnosis of LCH is often difficult and may be delayed because of its rarity and especially so if it occurs with unusual presentation.A high index of suspicion, awareness of characteristic cytological features of LCH and its differential diagnoses is necessary.This can obviate the need of biopsy and electron microscopy.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Topiwala National Medical College and B. Y. L. Nair Charitable Hospital, Mumbai, Maharashtra, India.

ABSTRACT
Langerhans cell histiocytosis (LCH) is a rare disease affecting predominantly children. The course of the disease varies, from spontaneous resolution to a progressive multisystem disorder with organ dysfunction and potential life-threatening complications. Diagnosis of LCH is often difficult and may be delayed because of its rarity and especially so if it occurs with unusual presentation. Fine needle aspiration cytology of a 4 year old male child, a case of LCH is presented with a purpose of highlighting the characteristic cytological features. A high index of suspicion, awareness of characteristic cytological features of LCH and its differential diagnoses is necessary. This can obviate the need of biopsy and electron microscopy. Immunohistochemistry if available can be performed on cytology smear and cell block.

No MeSH data available.


Related in: MedlinePlus