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

Cite this page: Langerhans cell histiocytosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/boneLCH.html. Accessed December 8th, 2016.
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
Treatment
Gross Description
  • Sharply circumscribed
Micro 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
Micro 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:

Pap stain of parietal bone

Touch preparation,
Diff-Quik stain -
contributed by Dr.
Mark R. Wick


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
Images hosted on PathOut server:

Birbeck granules - contributed by Dr. Mark R. Wick

Electron micrograph - contributed by Dr. Mark R. Wick

Molecular / Cytogenetics Description
Additional References