Langerhans Cell Histiocytosis (LCH) of the Tonsil in Adult Patient: An Uncommon Disease at an Uncommon Site

Abstract

Langerhans cell histiocytosis (LCH) is a rare disease characterized by clonal neoplastic proliferation of normal antigen presenting cell (APC), the Langerhans cell. Most cases occur in childhood and the disease is rare in adults. LCH can involve solitary organ or can present as a multi-system disease in children. In adults, isolated pulmonary LCH is the commonest presentation. Tonsillar infiltration as a sole manifestation is extremely rare. We herewith report a case with isolated tonsillar involvement by LCH in an adult patient.

Keywords: Langerhans cell; Langerhans cell histiocytosis (LCH); Tonsils.

Fig. 1

CT scan of the neck showing tonsillar swelling

Fig. 2

a, b H&E stained section showing tonsillar tissue lined by stratified squamous epithelium with subepithelium showing closely packed large cells in a background of numerous eosinophils and plasma cells. (100×, 400×)

Fig. 3

Immunohistochemistry (IHC) showing expression of CD1a (a), CD68 (b) and S100 (c) by large cells. (400×)