Bone
Other tumors of bone
Langerhans cell histiocytosis


Topic Completed: 1 June 2005

Revised: 11 July 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed search: langerhans cell histiocytosis [title] bone

Related topics: solitary bone involvement, multiple bone involvement, multiple organ involvement

Nat Pernick, M.D.
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Cite this page: Pernick N. Langerhans cell histiocytosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/boneLCH.html. Accessed July 20th, 2019.
Definition / general
  • Formerly called Histiocytosis X
  • Either solitary bone involvement, multiple bone involvement (variable skin involvement) or multiple organ involvement (bone, liver, spleen, other sites)
  • Ages 5 - 15 years, 60% male
  • Neoplastic, although cause unknown
  • Sites: skull, jaw, humerus, rib, femur; metaphysis or diaphysis
Radiology description
  • Lytic masses that may extend into soft tissue
Radiology images

Case of the Week #72

Involvement of both parietal bones with soft tissue extension #1 (plain film)

#2 (CT scan)


AFIP images

Eosinophilic granuloma


Contributed by Dr. Mark R. Wick

Skull xray

Case reports
Treatment
Gross description
  • Sharply circumscribed
Microscopic (histologic) description
  • Infiltration by Langerhans cells (polygonal cells with eosinophilic cytoplasm, oval nuclei with longitudinal grooves resembling coffee beans)
  • Eosinophils, giant cells, neutrophils, foam cells, lymphocytes, plasma cells, fibrosis, necrosis; may have typical and atypical mitotic figures
Microscopic (histologic) images

AFIP images

Eosinophilic granuloma


Contributed by Dr. Mark R. Wick

Langerhans cell disease



CD1a

Langerin stain

S100



Images hosted on other servers:

(a) H&E;
(b) CD1a



Contributed by Dr. Saroona Haroon, The Aga Khan University Hospital (Pakistan)

Cytology description
  • Highly cellular with large, polygonal cells with ample cytoplasm, nuclei are round, oval or bean shaped with fine and even chromatin and prominent longitudinal grooves
  • Inconspicuous nucleoli, mild pleomorphism
  • No / minimal mitotic figures
  • Scattered eosinophils and neutrophils and multinucleated osteoclast-like giant cells
  • Necrosis common
Cytology images

Case of the Week #72

Pap stain of parietal bone


Contributed by Dr. Mark R. Wick

Touch preparation,
Diff-Quik stain


Images hosted on other servers:

B: Diff Quik; C: Pap (arrow at eosinophil); D: CD1a; E: H&E

Positive stains
Negative stains
Electron microscopy description
  • Birbeck granules (electron dense cross striations)
Electron microscopy images

Contributed by Dr. Mark R. Wick

Birbeck granules

Electron micrograph

Molecular / cytogenetics description
Additional references
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