Solitary lymph node involvement by Langerhans Cell Hitisocytosis: Cytomorphologic diagnosis and pitfalls on Fine Needle Aspiration Cytology
Keywords:
Solitary, lymph node, Langerhans Cell Histiocytosis, FNAC
Abstract
Langerhans cell histiocytosis (LCH) is a rare disease and when confined to lymph node, it is even rarer. Lymph node involvement in LCH can be seen as a component of the systemic form or it may be the initial and sometimes exclusive manifestation of the disease [1].We present a case of LCH confined to the lymph node diagnosed initially by fine needle aspiration cytology (FNAC) in a 7 year old girl. Highly cellular smears showed fair number of large histiocytic cells (langerhans cells) showing round to oval vesicular nuclei with irregular folded and grooved nuclei with abundant, pale blue cytoplasm admixed with numerous neutrophils, lymphocytes, macrophages, multinucleated giant cells and tingible body macrophages suggesting the diagnosis of LCH. This was confirmed on histopathological and immunohistochemical study of the excised lymph node. The highly characteristic common and rare cytological features are highlighted with focus on differential diagnosis and causes of pitfalls.References
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2 Chandekar SA, Shah VB, Kavishwar V. Cytological diagnosis of Langerhans cell histiocytosis with cutaneous involvement. J Cytol 2013; 30: 81-3.
3 Degar BA, Rollins BJ. Langerhans cell histiocytosis: Malignancy or inflammatory disorder doing a great job of imitating one? Dis Model Mech. 2009;2:436–9.
4 Kumar N, Sayed S, Vinayak S. Diagnosis of Langerhans cell histiocytosis on fine needle aspiration cytology: A case report and review of the cytology literature. Patholog Res Int. 2011; 2011: 439518.
5 Kumar PV, Mousavi A, Karimi M, Bedayat GR. Fine needle aspiration of langerhans histiocytosis of lymphnodes: a report of six cases.Acta Cytol 2002; 46:753-6.
6 Kakkar S, Kapila K, Verma K. Langerhans cell histiocytosis in lymph nodes cytomorphologic diagnosis and pitfalls. Acta Cytologica. 2001;45(3):327–332.
7 Mukhopadhyay S, Mitra PK, Ghosh S. Touton like giant cell in lymph node in a case of langerhans cell histiocytosis. J Cytol. 2007;24:191–2.
8 Egeler RM, Neglia JP, Puccetti DM, Brennan CA, Nesbit ME. Association of Langerhans Cell Histiocytosis with Malignant Neoplasms. Cancer. 1993;71:865–73.
Published
2016-11-20
Issue
Section
Case Reports
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