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Langerhans cell histiocytosis in children diagnosed by fine-needle aspiration
Uma Handa1, Reetu Kundu1, Rajpal Singh Punia1
1Department of Pathology, Government Medical College and Hospital, Chandigarh, Punjab and Haryana, India.
Insights
Langerhans cell histiocytosis (LCH) in children can be diagnosed using fine-needle aspiration (FNA) cytology. Characteristic Langerhans cells (LCs) and S-100 protein positivity aid in diagnosis.
Area of Science:
- Pediatric Pathology
- Cytopathology
- Oncology
Background:
- Langerhans cell histiocytosis (LCH) is a rare pediatric neoplasm.
- LCH presents with diverse clinical manifestations and treatment options.
Purpose of the Study:
- To investigate the cytological characteristics of LCH.
- To explore differential diagnoses of LCH using fine-needle aspiration (FNA).
Main Methods:
- FNA was performed using a 23-gauge needle.
- Seven pediatric cases in the head and neck region were diagnosed with LCH via FNA.
Main Results:
- Cytological findings included isolated Langerhans cells (LCs) with specific nuclear features, multinucleated giant cells, eosinophils, and lymphocytes.
- Histopathology and S-100 immunohistochemistry confirmed LCH diagnosis.
- Patient age ranged from 25 days to 11 years; male-to-female ratio was 1:1.3.
Conclusions:
- FNA cytology is effective for diagnosing LCH in children.
- Characteristic Langerhans cells (LCs) on FNA smears facilitate diagnosis.
- S-100 positivity supports the diagnosis of LCH.
Background:
Langerhans cell histiocytosis (LCH) is a rare intricate pediatric neoplasm with varied clinical manifestations and multiple treatment modalities.
Aim:
To study the cytological features of LCH and the differential diagnoses on fine-needle aspiration (FNA).
Materials And Methods:
FNA was performed using a 23-gauge needle fitted to a 10 mL syringe mounted on syringe holder. LCH was diagnosed on FNA smears in seven cases confined to the head and neck region, which included three cases of lymphadenopathy, three cases of scalp swelling, and one case of orbital swelling.
Results:
The age of the patients ranged from 25 days to 11 years and male-to-female ratio was 1:1.3. Clinically, the diagnoses suggested were tuberculosis, inflammatory lesion, abscess, and malignancy. The cytologic findings included high cellularity, isolated Langerhans cells (LCs) with prominent nuclear indentation, grooves and abundant vacuolated cytoplasm, multinucleated giant cells, eosinophils, and lymphocytes. Areas of necrosis were noted in one case. Histopathology, along with positive S-100 immunohistochemistry, confirmed the diagnosis of LCH.
Conclusions:
LCH is a rare disease occurring predominantly in children and can be diagnosed with ease on FNA cytology by the presence of characteristic Langerhans cells. The S-100 positivity aids in suggesting a diagnosis of LCH.
