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Nodal Langerhans cell histiocytosis with prominent eosinophilic emperipolesis
Abhijit Chougule1, Shreya Srivastava1, Sidharth Totadri2
1Department of Cytology and Gynaec Pathology, Advanced Paediatric Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Multinucleated giant cells in Langerhans cell histiocytosis (LCH) lesions were observed engulfing intact inflammatory cells, particularly eosinophils. This previously undescribed emperipolesis phenomenon offers new insights into LCH pathogenesis and giant cell behavior.
Area of Science:
- Pathology
- Histiocytosis
- Cell Biology
Background:
- Multinucleated giant cells of osteoclastic type are characteristic of Langerhans cell histiocytosis (LCH) lesions.
- These giant cells are believed to originate from phagocytic histiocytes and their activity may correlate with lesion necrosis.
Observation:
- The study presents a unique case of LCH involving a lymph node.
- In this case, multinucleated giant cells of Langhans type exhibited emperipolesis, a phenomenon where intact cells are engulfed within the cytoplasm.
- Specifically, these giant cells were observed to phagocytose inflammatory cells, with a notable presence of eosinophils.
Findings:
- This report describes the novel finding of emperipolesis of inflammatory cells, including eosinophils, by multinucleated giant cells in a lymph node affected by LCH.
- This observation has not been previously documented in the scientific literature.
Implications:
- The findings suggest a more complex functional role for multinucleated giant cells in LCH beyond simple phagocytosis and tissue remodeling.
- Understanding emperipolesis in LCH could potentially lead to new diagnostic markers or therapeutic targets.
- This phenomenon may provide insights into the interaction between LCH cells and the inflammatory microenvironment.
Abstract:
Multinucleated giant cells of osteoclastic type are known to occur in nodal and extranodal lesions of Langerhans cell histiocytosis (LCH). These giant cells are thought to be derived from phagocytic histiocytes, which correlate with the degree of necrosis in LCH lesions. Emperipolesis commonly seen in Rosai-Dorfman disease is a distinct phenomenon characterized by intact phagocytosed cells in an intracytoplasmic vacuole protected from proteolytic digestion. We present a case of emperipolesis of inflammatory cells especially of eosinophils by multinucleated giant cells of Langhans type in a lymph node involved by LCH--a finding that has not been described previously in the literature.
