Thyroid gland
Other malignancies
Langerhans cell histiocytosis

Author: Sheren Younes, M.D. (see Authors page)

Revised: 17 February 2017, last major update December 2014

Copyright: (c) 2014-2017, PathologyOutlines.com, Inc.

PubMed Search: Langerhans cell histiocytosis thyroid

Cite this page: Langerhans cell histiocytosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/thyroidlch.html. Accessed October 21st, 2017.
Definition / general
  • Clonal proliferation of Langerhans cells
  • Thyroid involvement is rare
  • Isolated or part of disseminated disease
Epidemiology
  • Adults more than children, reported in both
  • No sex predilection
Clinical features
  • Thyroid mass or enlargement, must rule out malignant lesions
  • Thyroid function may be affected depending on degree of involvement
Diagnosis
  • Combination of clinical, radiologic, cytologic and histopathologic features
  • Immunohistochemistry and electron microscopy may play a role
Prognostic factors
Case reports
Treatment
  • Chemotherapy and surgery
Microscopic (histologic) description
  • Patchy to extensive involvement of thyroid gland, with follicle invasion and destruction
  • May show extrathyroid involvement
  • Langerhans cells have moderate eosinophilic cytoplasm and oval nuclei with grooves and a thin nuclear membrane
  • Also eosinophils, lymphocytes, multinucleated histiocytes
Microscopic (histologic) images

Images hosted on other servers:

Langerhans cell centrally located

High cellularity

Diffuse infiltration of thyroid gland

Involvement of parathyroid gland


Nests of tumor cells and eosinophils

CD1a

S100

Cytology description
  • Smears contain numerous histiocytic cells with moderate to abundant pale eosinophilic cytoplasm, ovoid to rounded vesicular nuclei, nuclear grooves
  • Moderate to marked pleomorphism is seen
  • Also eosinophils, lymphocytes, giant cells
  • Normal thyroid follicular cells and histiocytes are present (Acta Cytol 2004;48:278)
Negative stains
Electron microscopy description
  • Birbeck Granules: tennis racquet or zipper shaped structures, 33 nm wide with central serrated line