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Items 1-9 of 9 |
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Langerhans cell histiocytosis in lymph nodes. Cytomorphologic diagnosis and pitfalls.
Kakkar S, Kapila K, Verma K.
Cytopathology Laboratory, Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
OBJECTIVE: To delineate the cytomorphology of Langerhans cell histiocytosis (LCH) in lymph nodes. STUDY DESIGN: Nine histologically documented LCH cases with a prior lymph node aspirate and five more cases in which a cytologic diagnosis of LCH was rendered in a background of corroborative clinical and radiologic findings were included in a retrospective study over a 12-year period (January 1988-January 2000). Papanicolaou- and May-Grunwald-Geimsa-stained smears were reviewed by two independent observers. Staining for S-100 protein was available in four cases. RESULTS: Nine cases had multisystem involvement, while in five cases only lymph nodes were involved. The ages ranged from 5 months to 27 years, with 11 males and 3 females. An initial cytologic diagnosis of LCH had been rendered in six, suspected in four and missed in four. On review, all were reclassified as LCH except two cases, which were still thought to be reactive and necrotizing lymphadenitis. The pathognomic feature of LCH, the "LCH cell," was identified in 12 of 14 cases along with varying numbers of eosinophils, polymorphs and lymphocytes. Giant cells were seen in six cases, and plasma cells were rarely seen. CONCLUSION: Lymph node involvement by LCH can be identified by fine needle aspiration in 85% of cases. The presence of the LCH cell is a must. The differentials to be considered are dermatopathic lymphadenitis, sinus histiocytosis with massive lymph-adenopathy, Hodgkin's lymphoma and malignant histiocytosis.
PMID: 11393062 [PubMed - indexed for MEDLINE]
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Cytomorphology of Langerhans cell histiocytosis.
Pohar-Marinsek Z, Us-Krasovec M.
Department of Cytopathology, Institute of Oncology, Ljubljana, Slovenia.
OBJECTIVE: To determine the diagnostic accuracy in recognizing Langerhans cell histiocytosis (LCH) in cytologic smears obtained between 1977 and 1994 and to analyze the composition of these smears and thus identify various cytomorphologic patterns. STUDY DESIGN: The study group consisted of 37 cytologic smears (34 patients) taken from 30 bone lesions, 5 lymph nodes, 1 parotid gland and 1 conjunctival lesion. We noted the presence of various components in each smear and estimated their abundance. Immunocytochemical staining for S-100 protein was performed in seven cases. RESULTS: LCH was recognized in 22 cases, suspected in 5 and unrecognized in 1; one case was suspected of malignancy. Six smears were nondiagnostic. Three reactive lesions were misinterpreted as LCH. Smears contained numerous Langerhans cells (LCs), eosinophils, neutrophils, lymphocytes, macrophages and multinucleated giant cells. Some capillary fragments were usually present. The morphology of smears varied somewhat in the percentage of individual constituents present as well as in the appearance of the LCs. Immunocytochemical staining for S-100 protein was positive in six cases and equivocal in one. CONCLUSION: The cytomorphologic pattern of LCHs in fine needle aspiration biopsy smears is usually characteristic, and a correct diagnosis is possible, especially with the aid of immunocytochemistry. One must be aware, however, of different morphologic patterns of LCHs and of unusual appearances of LCs, which may lead to diagnostic errors.
PMID: 8960038 [PubMed - indexed for MEDLINE]
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The cytology of Langerhans cell histiocytosis (histiocytosis X).
Van Heerde P, Maarten Egeler R.
Department of Pathology, The Netherlands Cancer Institute, Amsterdam.
The cytomorphology of 13 cases of Langerhans cell histiocytosis is described. The most striking features were the presence of intranuclear clefts, pale nuclei and inconspicuous nucleoli, together with ample pale cytoplasm, only slight cellular pleomorphism, and an admixture of varying numbers of eosinophils, macrophages and degenerated cells. In 13 of 16 cases investigated ultrastructurally, characteristic Birbeck granules were detected. Out of six cases tested, four exhibited positivity for S-100, and of three cases tested, all were positive for CD1a (leu 6) and HLA-DR. In one case malignant transformation occurred, terminating in monocytic leukaemia.
PMID: 1932578 [PubMed - indexed for MEDLINE]
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Fine needle aspiration cytology of Langerhans cell histiocytosis confined to lymph nodes. A case report.
Lee JS, Lee MC, Park CS, Juhng SW.
Department of Pathology, Chonnam University Medical School, Kwangju, Seoul, Korea.
BACKGROUND: Lymph node involvement in Langerhans cell (LC) histiocytosis (LCH) can be seen as a component of the systemic form, or it may be the initial and sometimes exclusive manifestation of the disease. Descriptions of patients with LCH whose disease is confined to lymph nodes are rare. CASE: We present a case of LCH confined to lymph nodes initially diagnosed by fine needle aspiration (FNA) cytology in a 43-year-old male. The cytologic findings in LCH included high cellularity, isolated LCs with prominent nuclear indentations and grooves, multinucleate giant cells, eosinophils and lymphocytes. Confirmation of LCH was obtained by positive S-100 protein immunohistochemical staining and the demonstration of Birbeck granules on electron microscopy. CONCLUSION: The presence of LCs with prominent nuclear indentations and grooves is characteristic of LCH confined to lymph nodes and serves as a key point in suggesting the diagnosis of LCH.
PMID: 9390144 [PubMed - indexed for MEDLINE]
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Diagnosis of Langerhans cell histiocytosis by fine needle aspiration cytology.
Das DK, Nayak NC.
Publication Types:
PMID: 7484007 [PubMed - indexed for MEDLINE]
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Fine needle aspiration cytology of Langerhans cell histiocytosis of the thyroid. A case report.
Dey P, Luthra UK, Sheikh ZA.
Cytology Unit, Mubarak Al Kabeer Hospital, Kuwait.
BACKGROUND: Langerhans cell histiocytosis (LCH) of the thyroid is a rare condition, and fine needle aspiration cytology (FNAC) of this entity has rarely been described. CASE: FNAC was done on a 3-cm-diameter thyroid swelling in the left lower lobe of the thyroid gland. Smears showed a large number of lymphocytes, eosinophils, thyroid follicular cells and discrete, large cells with prominent nuclear grooves. Mitotic activity was frequent. A cytologic diagnosis of LCH was offered. Subtotal thyroidectomy was performed, and the cytologic diagnosis was confirmed by histology. CONCLUSION: LCH of the thyroid has certain salient diagnostic features. The presence of histiocytes with prominent nuclear grooves, reactive lymphoid cells and eosinophils along with benign thyroid follicular cells should raise the suspicion of this rare entity on FNAC smears of the thyroid.
PMID: 10349374 [PubMed - indexed for MEDLINE]
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Fine-needle aspiration biopsy of Langerhans histiocytosis (histiocytosis-X).
Akhtar M, Ali MA, Bakry M, Sackey K, Sabbah R.
Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
A series of 14 fine-needle aspiration biopsies (FNAB) from histologically proven cases of histiocytosis-x (Hx) were reviewed. The smears revealed a variable mixture of Langerhans cells, eosinophils, macrophages, polymorphonuclear cells, and giant cells. Based on the predominant cells present, the cases were further categorized as Langerhans cell predominant (nine cases), eosinophil predominant (two cases), and macrophage predominant (three cases). Langerhans cells were usually polygonal without significant evidence of phagocytosis and frequently contained indented nuclei. In three cases, several Langerhans cells showed prominent dendritic processes. Electron microscopy in 10 cases revealed Langerhans cells with varying degrees of morphologic differentiation. All cases studied revealed Birbeck granules. These findings indicate that FNAB may be an effective technique for diagnosing Hx.
PMID: 8287761 [PubMed - indexed for MEDLINE]
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Fine-needle aspiration cytology of Langerhans' cell histiocytosis (eosinophilic granuloma) of bone in children.
Elsheikh T, Silverman JF, Wakely PE Jr, Holbrook CT, Joshi VV.
Department of Pathology and Laboratory Medicine, East Carolina University School of Medicine, Greenville, NC 27858-4354.
Fine-needle aspiration (FNA) cytology of three cases of Langerhans' cell histiocytosis (eosinophilic granuloma [EG]) of bone in children (mean age--8.3 yr; range 5-11 yr) is presented. Two patients presented with vertebral lesions and the third had a femoral mass. Cytomorphologic features of EG were seen in all cases including Langerhans' cell histiocytes having oval to reniform shape nuclei with nuclear grooving and abundant pale cytoplasm. The background showed a polymorphic population of cells including neutrophils, lymphocytes, foamy histiocytes, and osteoclasts. Moderate numbers of eosinophils were seen in two cases, while eosinophils were sparse in the third case. Ancillary immunocytochemical (ICC) studies performed on the aspirated material demonstrated positive staining for S-100 protein (all three cases) and T-6 antigen (one case). Ultrastructural examination (EM) performed in one case demonstrated characteristic Birbeck granules in the histiocytes. A specific cytologic diagnosis was made in all cases, enabling proper chemotherapy in one case, surgical excision in another and spontaneous resolution in the third case. Our experience demonstrates that FNA cytology can make a definitive diagnosis of EG, especially when coupled with ancillary studies such as ICC and EM on the aspirated material.
PMID: 1879261 [PubMed - indexed for MEDLINE]
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Eosinophilic granuloma of lymph node: case report with cytohistologic, immunohistochemical, and flow cytometric observations.
Granger JK, Houn HY.
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock 72205.
A case study of eosinophilic granuloma (Langerhans cell histiocytosis) of lymph node in a 32-year-old white man is presented. Clinical, cytologic, histologic, immunohistochemical, and flow cytometric findings are reported. Intraoperative cytologic findings can serve as valuable adjuncts to the frozen section, in this case serving as the sole method for diagnosis. This case is presented in light of the rarity of node-based eosinophilic granuloma and the absence of flow cytometric immunophenotypic findings in the literature.
PMID: 1935519 [PubMed - indexed for MEDLINE]
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Items 1-9 of 9 |
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One page. |
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