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Langerhans cell histiocytosis of the skull on cytologic squash preparations
Author(s) -
Kobayashi Tadao K.,
Ueda Masami,
Nishino Toshihiro,
Bamba Masamichi,
Echigo Tadashi,
Oka Hideki,
Hino Akihiko,
Fuse Ikuko,
Fujimoto Masato,
Katsumori Tetsuya,
Kaneko Chiyuki
Publication year - 2007
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.20597
Subject(s) - birbeck granules , histiocyte , langerhans cell histiocytosis , pathology , skull , medicine , population , cytopathology , histiocytosis , langerhans cell , cytology , anatomy , disease , environmental health , antigen , immunology
Abstract We present a case in which a primary cytodiagnosis of Langerhans cell histiocytosis (LCH) of the skull was made using squash preparations. The patient, a 25‐year‐old male, presented with raised intracranial pressure and decreased visual acuity. Magnetic resonance imaging revealed a large skull lesion with osteolytic features in the left frontal bone. The patient underwent surgical resection by the extended basal frontal epidural approach. The squash preparation smears were cellular and demonstrated a mixed population of small, mature lymphocytes, eosinophils, and a high histiocytes content. The histiocytes occurred as isolated or loosely cohesive and clustered. They possessed abundant cytoplasm with rounded cell shape and had characteristic nuclear features, composed of fine chromatin and delicate nuclear membranes. The cytologic features of these histiocytes were consistent with Langerhans cells (LCs). A final impression of LCH of the skull was rendered. Subsequent histopathology confirmed the diagnosis. LCs reacted with both S‐100 protein and CD1a immunohistochemically. The demonstration of Birbeck granules on electron microscopic study was also noted. Whenever squash preparation yields a mixed population of mature lymphocytes, eosinophils, and histiocytes, the cytologists should be aware of and consider LCH as a diagnostic possibility. Diagn. Cytopathol. 2007;35:154–157. © 2007 Wiley‐Liss, Inc.