Persistence Pays Off: Adult Langerhans Cell Histiocytosis

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Presentation transcript:

Persistence Pays Off: Adult Langerhans Cell Histiocytosis Elizabeth Nguyen, MD, PhD, Dru Claar, MD, Erin McGuinn, MD, Kelley Mast, MD, Katherine Hartley, MD, Kevin McDonagh, MD The American Journal of Medicine Volume 129, Issue 7, Pages e55-e59 (July 2016) DOI: 10.1016/j.amjmed.2016.02.018 Copyright © 2016 Terms and Conditions

Figure 1 Hematoxylin and eosin-stained sections showing fibrosis and multiple nonnecrotizing granulomas (A, 5×) composed of epithelioid histiocytes (B, 20×) without nuclear grooves (C, 60×) in a background of lymphoplasmacytic inflammation. Histiocytes positive for CD1a by immunohistochemistry (D, 40×). The American Journal of Medicine 2016 129, e55-e59DOI: (10.1016/j.amjmed.2016.02.018) Copyright © 2016 Terms and Conditions

Figure 2 Axial pre (A) and post (B) gadolinium enhanced fat-suppressed T1W magnetic resonance (MR) images of the pelvis and sagittal (C) nonenhanced T1W MR spine image demonstrating widespread, nonsclerotic, nodular, enhancing, marrow replacing lesions throughout the skeleton. The American Journal of Medicine 2016 129, e55-e59DOI: (10.1016/j.amjmed.2016.02.018) Copyright © 2016 Terms and Conditions

Figure 3 The computed tomography (CT) imaging appearance of osseous disease was highly variable. As shown here (A), many were invisible. Those seen were lytic (*). The varied appearance of margins may be attributed to lesions in different phases. Although not as useful for characterizing extent of disease, CT-guided core biopsy of a right iliac lesion (B) ultimately led to diagnosis. The American Journal of Medicine 2016 129, e55-e59DOI: (10.1016/j.amjmed.2016.02.018) Copyright © 2016 Terms and Conditions

Figure 4 Hematoxylin and eosin-stained sections showing hypercellular bone marrow with fibrosis and multifocal granulomas (A, 5×) composed of epithelioid histiocytes (B, 20×) with longitudinal nuclear grooves (C, 60×) in a background of lymphoplasmacytic inflammation. Histiocytes positive for CD1a by immunohistochemistry (D, 40×). The American Journal of Medicine 2016 129, e55-e59DOI: (10.1016/j.amjmed.2016.02.018) Copyright © 2016 Terms and Conditions