Korean J Cytopathol.  2007 Mar;18(1):87-91.

Fine Needle Aspiration Cytology of Langerhans Cell Histiocytosis in a Lymph Node: A Case Report

• Ha SY
• Kim MJ
• Kim GY
• Cho HY
• Chung DH
• Kim NR

Abstract

Langerhans cell histiocytosis (LCH) is a pleomorphic disease entity characterized by local or disseminated atypical Langerhans cells (LCs) found most commonly in bone, lungs, mucocutaneous structures and endocrine organs. Among different sites, unifocal disease confined to a lymph node (LN) is rare. We report a case of LCH confined to a LN in a 38-year-old male who presented with a 2 cm-sized cervical mass. The fine needle aspiration (FNA) smears of cervical LN showed high cellularity having isolated LCs with contorted nuclei and nuclear grooves mixed in multinucleated giant cells, small lymphocytes and eosinophils. Charcot-Leyden crystals were also seen, as were a few dendritic-like cells and intranuclear inclusions. Confirmation of LCH was made by histopathologic studies, positive reactions for S-100 protein and CD1a immunohistochemical staining and by the demonstration of Birbeck granules on electron microscopy. The differentials to be considered include dermatopathic lymphadenitis, sinus histiocytosis with massive lymphadenopathy, Hodgkin's lymphoma and malignant histiocytosis. The characteristic cytomorphologic pattern of LCH in a LN FNA smear plays an important role in suggesting the diagnosis of LCH.

Keyword

Langerhans cell histiocytosis; Lymph node; Aspiration cytology

MeSH Terms

Adult
Biopsy, Fine-Needle*
Diagnosis
Eosinophils
Giant Cells
Histiocytic Sarcoma
Histiocytosis, Langerhans-Cell*
Histiocytosis, Sinus
Hodgkin Disease
Humans
Intranuclear Inclusion Bodies
Langerhans Cells
Lung
Lymph Nodes*
Lymphadenitis
Lymphocytes
Male
Microscopy, Electron
S100 Proteins
S100 Proteins