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Occult Langerhans Cell Histiocytosis in Clear Cell Renal Cell Carcinoma
Hee Jung Kwon1, Phil Hyun Song1, Mi Jin Gu1
11 Yeungnam University, Daegu, South Korea.
Insights
This case report details an uncommon instance of occult Langerhans cell histiocytosis discovered within clear cell renal cell carcinoma in a 62-year-old man. Further examination revealed no other signs of this rare dendritic cell proliferation disease.
Area of Science:
- Oncology
- Pathology
- Dermatology
Background:
- Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disease of Langerhans dendritic cells.
- LCH presents with diverse clinical manifestations, ranging from localized to systemic involvement.
- The association between LCH and renal cell carcinoma is exceedingly rare.
Observation:
- A 62-year-old male presented with a renal mass, diagnosed as clear cell renal cell carcinoma.
- Histopathological examination revealed a distinct nodule of atypical mononuclear cells with eosinophils within the renal tumor.
- Immunohistochemical analysis confirmed these cells as Langerhans cell histiocytes, positive for S-100 and CD1a.
Findings:
- The study identified an unusual co-occurrence of Langerhans cell histiocytosis (LCH) and clear cell renal cell carcinoma (ccRCC).
- The LCH was occult, presenting as an incidental finding within the renal tumor.
- Comprehensive follow-up evaluations did not reveal any other systemic lesions of LCH.
Implications:
- This case highlights the importance of thorough histopathological evaluation, especially in rare tumor co-occurrences.
- The findings may prompt further investigation into potential shared pathways or associations between LCH and renal neoplasms.
- Recognizing this rare association is crucial for accurate diagnosis and patient management.
Abstract:
Langerhans cell histiocytosis is a rare disease that is characterized by a localized or systemic proliferation of Langerhans dendritic cells and a wide spectrum of clinical presentations. We experienced an unusual case of occult Langerhans cell histiocytosis associated with clear cell renal cell carcinoma. A 62-year-old man underwent a partial nephrectomy for left renal mass. Histologic examination showed nests of clear cells with surrounding thin-walled vessel that were suggestive of clear cell renal cell carcinoma. A well-defined nodule composed of atypical mononuclear cells and plentiful eosinophils presented within clear cell renal cell carcinoma. The mononuclear cells were Langerhans cell histiocytes with S-100 and CD1a immunoreactivity. On follow-up comprehensive physical, laboratory, and radiologic examination, there were no other lesions of Langerhans cell histiocytosis.
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