Langerhans cell histiocytosis followed by hodgkin lymphoma: a case report

Abstract

Langerhans cell histiocytosis (LCH) is a rare neoplasm defined as the proliferation of bone marrow langerhans cells, which is a kind of dendritic cells. The major pathological features of LCH are expression of CD1a and S100 as well as Birbeck granules. Its presentation can differ from a mild bone lesion to a multi-systemic evolved malignant neoplasm; however, the latter outcome is almost rare. Thus, LCH is mostly known as a benign neoplasm. In this study, we present a case of LCH followed by Hodgkin lymphoma (HL). Accompaniment of this disease with malignant lymphoma is rare and considered as case report. Several cases in which malignant lymphoma occurred prior to LCH are reported; however, few cases can be found with LCH followed by malignant lymphomas.

Keywords: Hodgkin disease; Immunohistochemistry; Langerhans cell histiosis.

Figure 1

Langerhans cell histiocytosis. A &B: Infiltration of lymphocyte, plasma cells, eosinophils and many histiocytes with vesicular nucleus (H&E, x 200 & 400). C: Strong immunoreactivity of the histiocytes for CD1a (H&E, ×400)

Figure 2

A) Low power view of Hodgkin lymphoma at the right side and langerhans cell histiocytosis at the left side (H&E, ×200). B) High power view of Hodgkin lymphoma with many Reed-Sternberg cells (arrow). These cells have mono and binucleated vesicular nucleus with conspicuous nucleoli (H&E, ×400). C-E: Immunoreactivity of Reed-Sternberg cells with CD30, CD15, and weak staining with PAX5 (H&E, ×400)