Langerhans cell histiocytosis

Bone
Other tumors of bone
Langerhans cell histiocytosis

Author: Nat Pernick, M.D. (see Authors page)

Revised: 19 October 2016, last major update June 2005

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed search: langerhans cell histiocytosis [title] bone

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

Table of Contents

Cite this page: Langerhans cell histiocytosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/boneLCH.html. Accessed July 14th, 2017.

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

Images hosted on PathOut server:

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

#2 (CT scan)

Skull xray - contributed by Dr. Mark R. Wick

Eosinophilic granuloma

Case reports

2 year old boy with tender, palpable mass in right parietal region (Case of the Week #72)

Treatment

Often recurs after excision (Pediatr Blood Cancer 2007;48:696)

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

Images hosted on PathOut server:

Eosinophilic granuloma

Langerhans cell disease - contributed by Dr. Mark R. Wick

CD1a - contributed by Dr. Mark R. Wick

Langerin stain - contributed by Dr. Mark R. Wick

S100 - contributed by Dr. Mark R. Wick

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

Images hosted on PathOut server: