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Langerhans cell histocytosis (LCH) is a group of clinical conditions of unknown etiology characterized by clonal proliferation of bone marrow Langerhans like cells either in situ, leading to isolated bone lesions or, having spread in different remote tissues, potentially capable of inducing multisystem disease. Sometimes there are mutations (BRAF gene) 1 in Langerhans cells as they form. These changes may make the Langerhans cells grow and multiply quickly. This causes LCH cells to build up in certain parts of the body, where they can damage tissue or form lesions. Historically, the disease was confirmed by showing birbeck granules by electron microscopy, but currently the diagnosis is based on immunostaining showing presence of CD1a and / or langerin. Papillary thyroid carcinoma (PTC) is a well differentiated epithelial neoplasm. It is more common in women. Although it affects all age groups, the mean age at diagnosis is 40 years. Prognosis is good in patients aged ≤45 years (more than 90%). PTCs manifest themselves as nodules, and diagnosis relies on patient‟s clinical parameters, ultrasonography, and fine needle aspiration cytology. Few cases have been reported of thyroid gland involvement coexsistently by LCH and Papillary carcinoma. We do present a case of thyroid involvement by LCH and papillary carcinoma coexsistently with diagnostic controversy between aspiration cytology and histopathology.

Langerhans Cell Histiocytosis Co-Existing with Papillary Carcinoma of Thyroid – A Rare Surgical Challenge