Other tumors of bone
Langerhans cell histiocytosis

Topic Completed: 1 June 2005

Revised: 3 January 2019

Copyright: (c) 2003-2019,, Inc.

PubMed search: langerhans cell histiocytosis [title] bone

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

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Cite this page: Pernick N Langerhans cell histiocytosis. website. Accessed May 23rd, 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

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

#2 (CT scan)

Eosinophilic granuloma

Contributed by Dr. Mark R. Wick

Skull xray

Case reports
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

Eosinophilic granuloma

Contributed by Dr. Mark R. Wick

Langerhans cell disease

Contributed by Dr. Mark R. Wick


Langerin stain


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

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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