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Cytological diagnosis of Langerhans cell histiocytosis. Apropos 2 cases
Eleni Thodou, Konstantina Papaharalambous, Eleni Lappa
1Department of Pathology-Cytopathology, University Hospital of Heraklion, Voutes, Heraklion, Crete, Greece. dtamiolakis@yahoo.com.
Insights
Cytology accurately diagnoses Langerhans cell histiocytosis (LCH) in children and adults, reducing the need for biopsies. This method is valuable where histopathology services are limited.
Area of Science:
- Oncology
- Pathology
- Pediatrics
Background:
- Langerhans cell histiocytosis (LCH) presents with diverse clinical manifestations in pediatric and adult populations.
- LCH can range from localized, favorable lesions to aggressive, disseminated disease.
- Accurate and timely diagnosis is crucial for appropriate patient management.
Purpose of the Study:
- To highlight the diagnostic utility of cytology in Langerhans cell histiocytosis (LCH).
- To present cases where cytological findings led to the diagnosis of LCH.
- To emphasize the role of cytology as an alternative to biopsy, especially in resource-limited settings.
Main Methods:
- Review of two cases diagnosed with Langerhans cell histiocytosis (LCH).
- Cytological evaluation including characteristic cytomorphology.
- Application of selected immunocytochemistry for diagnostic confirmation.
Main Results:
- Cytology successfully introduced the diagnosis of LCH in both presented cases.
- Cytomorphology and immunocytochemistry provided accurate LCH interpretation.
- Cytology offers a viable diagnostic approach, potentially avoiding unnecessary biopsies.
Conclusions:
- Cytology is an accurate method for diagnosing Langerhans cell histiocytosis (LCH) when characteristic features are present.
- Immunocytochemistry aids in confirming LCH diagnoses made via cytology.
- Cytological diagnosis is particularly beneficial in settings lacking histopathology services, enabling prompt treatment adjustments.
Abstract:
Langerhans cell histiocytosis (LCH) comprises a wide spectrum of clinical presentations in children and adults, ranging from favorable lesions to aggressive disseminated disease. We present 2 cases where cytology introduced the diagnosis of LCH in the appropriate clinicoradioliogical settings. Cytology can serve accurately in LCH interpretation based on the characteristic cytomorphology and selected immunocytochemistry, so unwarranted biopsy can be overruled and treatment can be adjusted largely where histopathology services are unavailable. Diagnosis may be difficult in cases with scant or insufficient cellular material.
