Langerhans cell histiocytosis followed by Hodgkin's lymphoma

Abstract

A 22-year-old man was referred to our institution due to lower back pain and was diagnosed with Langerhans cell histiocytosis of the thoracic and lumbar spine. The patient achieved complete remission with radiotherapy and chemotherapy. One year later, right cervical lymphadenopathy was observed and Hodgkin's lymphoma was confirmed on biopsy. The patient was treated with chemotherapy and autologous stem cell transplantation, and experienced no further symptoms. Further, no evidence of recurrence was observed on follow-up imaging. This report discusses the association between Langerhans cell histiocytosis and Hodgkin's lymphoma.

Keywords: Histiocytosis; Hodgkin disease; Langerhans-cell histiocytosis.

Figure 1

Biopsy specimen of the T2 spinal lesion showed intramedullary proliferation of histiocytic cells with folded nuclei, numerous eosinophils, and phagocytic histiocytes, accompanied by dense collagenous fibrosis and vascular proliferation (H&E, × 100).

Figure 2

The cut surface of the enlarged lymph node was a glistening yellowish-tan color with diffuse nodularity.

Figure 3

(A) Microscopic examination showed broad sclerotic fibrous bands dividing the lymph node into multiple nodules (H&E, × 100). (B) The lymph node showed residual histiocytosis in the left field and classical Hodgkin's lymphoma in the right field (H&E, × 400).

Figure 4

Immunohistochemical staining. (A) CD1a-positive Langerhans cells were observed in the residual histiocytes (× 400). (B) CD30 (Ki-1)-positive Reed-Sternberg cells and mononuclear Hodgkin's cells are observed in Hodgkin's lymphoma (× 400).