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Case report
2022
Year : 2022 Month : July Volume : 11 Issue : 3 Page : PC01 - PC03 Full Version

Langerhans Cell Histiocytosis without Eosinophilia and Lytic Lesions of Bone: A Rare Disease with Unusual Presentation



Published: July 1, 2022 | DOI: https://doi.org/10.7860/NJLM/2022/55124.2637
Shruti Chauhan, Sunita Sharma, Smita Singh, Sharmila B Mukherjee
1. Assistant Professor, Department of Pathology, Lady Hardinge Medical College, Delhi, India. 2. Director Professor, Department of Pathology, Lady Hardinge Medical College, Delhi, India. 3. Professor, Department of Pathology, Lady Hardinge Medical College, Delhi, India. 4. Director Professor, Department of Paediatrics, Lady Hardinge Medical College, Delhi, India
 
Correspondence Address :
Shruti Chauhan, Sunita Sharma, Smita Singh, Sharmila B Mukherjee,
Dr. Shruti Chauhan,
C-106, Shaheed Bhagat Singh Marg, LHMC, New Delhi, India
E-mail: shrutichauhan19aug@gmail.com
 
ABSTRACT
: LCH is a disease of abnormal clonal proliferation of langerhans cell of the bone marrow derived monocyte-macrophage lineage. Cells with characteristic coffee bean / grooved / indented nuclei with a background of histiocytes, lymphocytes, eosinophils and other inflammatory cells are seen. Clinical presentation varies from unifocal unisystem to multifocal unisystem to multifocal multisystem. We present a rare case of multisystem LCH involving high risk organs in a two and a half year old child. presented with the chief complaints of fever and red raised maculopapular lesions on trunk, palm, forehead and scalp for one and a half yrs with hepatosplenomegaly. There were no lytic lesions of the bones. Hematological parameters showed anaemia with thrombocytopenia while Bone Marrow Aspirate showed increase in histiocytic cell with some cells showing characteristic coffee bean, cleaved irregularly contoured nuclei. However, eosinophilia was not seen. Sections from the skin lesions showed cells with similar morphology without usually accompanied eosinophilia. The cells were CD1a and S100 positive. So a FINAL DIAGNOSIS of langerhans cell histiocytosis was made. The emphasis here lies on thorough analysis of the clinical presentations, imaging studies and scrupulous histomorphological and immunohistochemical examination, so that early diagnosis and timely intervention is ensured in such cases where the characteristic features like lytic lesions of bone and eosinophilia is not found.
Keywords : Benign, Histopathology, Haematological, Multisystem, Pathogenesis, Prognosis
DOI and Others : DOI: 10.7860/NJLM/2022/55124.2637 Date of Submission: Jan 21, 2022 Date of Peer Review: Feb 11, 2022 Date of Acceptance: Mar 17, 2022 Date of Publishing: Jul 01, 2022 AUTHOR DECLARATION: • Financial or Other Competing Interests: None • Was informed consent obtained from the subjects involved in the study? Yes • For any images presented appropriate consent has been obtained from the subjects. Yes PLAGIARISM CHECKING METHODS: • Plagiarism X-checker: Jan 24, 2022 • Manual Googling
 
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