1
|
Shaker N, Shaker N, Abu Shakra R, Yenwongafi L, Pradhan D, Sangueza OP. Pulmonary Langerhans Cell Histiocytosis Post-Hodgkin Lymphoma Completely Resolved With Vinblastine in a Heavy Smoker: Coincidence or Causation? Int J Surg Pathol 2024:10668969241253216. [PMID: 38767149 DOI: 10.1177/10668969241253216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
The association among Langerhans cell histiocytosis, hematolymphoid malignancies, and heavy smoking has been addressed in medical literature to identify a possible potential link. Such occurrence can pose diagnostic challenges, as well as important clinical implications for disease progression and treatment approaches. We present pulmonary Langerhans cell histiocytosis instance in a 35-year-old male patient, with a 34-pack-year smoking history and nodular sclerosing Hodgkin lymphoma stage IIB who developed multiple bilateral lung nodules. The patient completed 6 cycles of doxorubicin (Adriamycin), bleomycin, vinblastine, and dacarbazine chemotherapy and radiotherapy 2 years earlier. CT chest scans revealed numerous micronodules scattered randomly throughout the upper and lower left lung lobes. Subsequent wedge resection exhibited cellular proliferation with grooved nuclei, eosinophilic cytoplasm, and surrounding inflammatory components. Immunohistochemical staining showed positive staining for S100 and CD1a confirming a diagnosis of pulmonary Langerhans cell histiocytosis. The patient responded to a 6-week treatment with vinblastine and prednisolone. A subsequent CT scan of the lungs revealed complete resolution after 3 years. This report underscores the importance of identifying pulmonary Langerhans cell histiocytosis in heavy smokers with Hodgkin lymphoma presenting with multiple nodular pulmonary lesions. For patients with Hodgkin lymphoma and a possible genetic predisposition, smoking may contribute to the overt development of pulmonary Langerhans cell histiocytosis. Therefore, smoking cessation and careful follow-up examinations are required. Further research is recommended to elucidate the underlying mechanisms of this intriguing association.
Collapse
Affiliation(s)
- Nada Shaker
- Pathology and Laboratory Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Nuha Shaker
- University of Pittsburgh Medical Center Health System, Pittsburgh, PA, USA
| | - Rafat Abu Shakra
- Department of Pathology, International Medical Center Hospital, Jeddah, Saudi Arabia
| | | | | | - Omar P Sangueza
- Departments of Dermatology and Dermatopathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
2
|
Louis M, Copper C, Lelli E, Conway J, Sarmiento D, Singh H. From terminal ileum to terminal diagnosis: The critical role of terminal ileum intubation in diagnosing langerhans cell histiocytosis in a patient with TAR syndrome. Radiol Case Rep 2024; 19:2052-2057. [PMID: 38444598 PMCID: PMC10914551 DOI: 10.1016/j.radcr.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 03/07/2024] Open
Abstract
The co-occurrence of Thrombocytopenia with Absent Radius (TAR) syndrome and Langerhans Cell Histiocytosis (LCH) is exceedingly rare, with scant documentation in existing medical literature. This case report aims to shed light on this unique intersection of conditions, emphasizing the diagnostic and therapeutic challenges it presents. A 27-year-old female with a history of TAR syndrome presented with microcytic anemia, hip pain, and gastrointestinal symptoms. Terminal ileum intubation during colonoscopy revealed superficial ulcerations, leading to a biopsy that confirmed LCH. Subsequent radiologic investigations, including CT and MRI, showed multiple osseous lesions in the pelvis, sacrum, and skull. A treatment plan involving IV Cytarabine was initiated due to concerns of CNS involvement, as indicated by mastoid air cell involvement and symptoms of dizziness and ear fullness. The case highlights the diagnostic value of terminal ileum intubation during colonoscopy, which was pivotal in diagnosing LCH in this patient. It also discusses the use of IV cytarabine, a chemotherapy drug that inhibits DNA synthesis, as a suitable treatment option given the suspected CNS involvement. The case adds to the limited literature on the natural history and management of adult patients with LCH, particularly in the context of TAR syndrome. This case report serves as a compelling addition to medical literature, highlighting the diagnostic complexities and treatment considerations in a patient with both TAR syndrome and LCH. It emphasizes the importance of comprehensive diagnostic approaches, including terminal ileum intubation during colonoscopy, and introduces IV cytarabine as a viable treatment option for cases with suspected CNS involvement.
Collapse
Affiliation(s)
- Mena Louis
- Northeast Georgia Medical Center, General Surgery GME Program, Gainesville, Georgia, USA
| | - Chad Copper
- Northeast Georgia Medical Center, Northeast Georgia Physician Group, Gainesville, Georgia, USA
| | - Elaine Lelli
- Northeast Georgia Medical Center, General Surgery GME Program, Gainesville, Georgia, USA
| | - Joseph Conway
- Northeast Georgia Medical Center, Gainesville Regional Pathology Associates, Gainesville, Georgia, USA
| | - Daniel Sarmiento
- Northeast Georgia Medical Center, Northeast Georgia Physician Group, Gainesville, Georgia, USA
| | - Hardeep Singh
- Northeast Georgia Medical Center, Graduate Medical Education, Research Department, Gainesville, Georgia, USA
| |
Collapse
|
3
|
Xu Y, Lu X, Wang W, Yang J. Coexistence of Langerhans Cell Histiocytosis and Ganglioneuroblastoma Revealed by 18 F-FDG PET/CT in a Pediatric Patient. Clin Nucl Med 2024; 49:371-372. [PMID: 38350091 DOI: 10.1097/rlu.0000000000005072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
ABSTRACT Coexistence of Langerhans cell histiocytosis and ganglioneuroblastoma is rare and seldom reported in the literature. A 3-year-old girl with Langerhans cell histiocytosis underwent 18 F-FDG PET/CT imaging for staging, which demonstrated significant 18 F-FDG accumulation in the mandibles. Unexpectedly, a mild hypermetabolic soft mass was detected in the upper retroperitoneum. Results of surgical pathology of the abdominal mass were consistent with ganglioneuroblastoma.
Collapse
Affiliation(s)
- Yanfeng Xu
- From the Department of Nuclear Medicine, Beijing Friendship Hospital of Capital Medical University, Beijing, China
| | | | | | | |
Collapse
|
4
|
Kemps PG, Kester L, Scheijde-Vermeulen MA, van Noesel CJM, Verdijk RM, Diepstra A, van Marion AMW, Dors N, van den Bos C, Bruggink AH, Hogendoorn PCW, van Halteren AGS. Demographics and additional haematologic cancers of patients with histiocytic/dendritic cell neoplasms. Histopathology 2024; 84:837-846. [PMID: 38213281 DOI: 10.1111/his.15127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/28/2023] [Accepted: 12/13/2023] [Indexed: 01/13/2024]
Abstract
AIMS The discovery of somatic genetic alterations established many histiocytic disorders as haematologic neoplasms. We aimed to investigate the demographic characteristics and additional haematologic cancers of patients diagnosed with histiocytic disorders in The Netherlands. METHODS AND RESULTS We retrieved data on histiocytosis patients from the Dutch Nationwide Pathology Databank (Palga). During 1993 to 2022, more than 4000 patients with a pathologist-assigned diagnosis of a histiocytic disorder were registered in Palga. Xanthogranulomas were the most common subtype, challenging the prevailing assumption that Langerhans cell histiocytosis (LCH) is the most common histiocytic disorder. LCH and juvenile xanthogranuloma (JXG) had a peak incidence in the first years of life; males were overrepresented among all histiocytosis subgroups. 118 patients had a histiocytic disorder and an additional haematologic malignancy, including 107 (91%) adults at the time of histiocytosis diagnosis. In 16/118 patients, both entities had been analysed for the same genetic alteration(s). In 11 of these 16 patients, identical genetic alterations had been detected in both haematologic neoplasms. This included two patients with PAX5 p.P80R mutated B cell acute lymphoblastic leukaemia and secondary histiocytic sarcoma, further supporting that PAX5 alterations may predispose (precursor) B cells to differentiate into the myeloid lineage. All 4/11 patients with myeloid neoplasms as their additional haematologic malignancy had shared N/KRAS mutations. CONCLUSIONS This population-based study highlights the frequency of xanthogranulomas. Furthermore, our data add to the growing evidence supporting clonal relationships between histiocytic/dendritic cell neoplasms and additional myeloid or lymphoid malignancies. Particularly adult histiocytosis patients should be carefully evaluated for the development of these associated haematologic cancers.
Collapse
Affiliation(s)
- Paul G Kemps
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Lennart Kester
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | | | - Carel J M van Noesel
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Robert M Verdijk
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Pathology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Arjan Diepstra
- Department of Pathology, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Natasja Dors
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Cor van den Bos
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | | | | | - Astrid G S van Halteren
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Internal Medicine, Section Clinical Immunology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| |
Collapse
|
5
|
Beckmann S, Kliffen M, Huijben A, Dubbink HJ, Sandberg Y. Concurrent Langerhans Cell Histiocytosis and Acute Myeloid Leukemia Without Clonal Relationship. JAMA Dermatol 2024; 160:115-116. [PMID: 37966814 DOI: 10.1001/jamadermatol.2023.4360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
This case report describes a woman in her 30s who had been treated with chemotherapy and presented with Langerhans cell histiocytosis and acute myeloid leukemia (AML).
Collapse
Affiliation(s)
- Sebastian Beckmann
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands
| | - Mike Kliffen
- Department of Pathology, Maasstad Hospital, Rotterdam, the Netherlands
| | - Auke Huijben
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands
| | | | - Yorick Sandberg
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands
| |
Collapse
|
6
|
Goyal G, Acosta-Medina AA, Abeykoon JP, Dai C, Ravindran A, Vassallo R, Ryu JH, Shah MV, Bennani NN, Young JR, Bach CR, Ruan GJ, Zanwar S, Tobin WO, Koster MJ, Davidge-Pitts CJ, Gruber LM, Dasari S, Rech KL, Go RS. Long-term outcomes among adults with Langerhans cell histiocytosis. Blood Adv 2023; 7:6568-6578. [PMID: 37698994 PMCID: PMC10641096 DOI: 10.1182/bloodadvances.2023010706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/11/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023] Open
Abstract
Advances in the treatment of Langerhans cell histiocytosis (LCH) have resulted in a growing survivor population. There is a lack of data on long-term outcomes among adults with LCH. We conducted a retrospective record review of 219 adults (aged ≥18 years) with LCH. Most common presentation was multisystem (34.2%), followed by single-system pulmonary (32%), unifocal (28.3%), and single-system multifocal (5.5%) LCH. Risk organ involvement (the liver, spleen, or bone marrow) was seen in 8.7% of cases, and 40 of 88 (45.5%) tested cases were BRAFV600E. At a median follow-up of 74 months, 5-year progression-free survival (PFS) was 58.3% and estimated median PFS was 83 months. Median overall survival (OS) was not reached; 5- and 10-year OS rates were 88.7% and 74.5%, respectively. Risk organ involvement was associated with worse PFS (hazard ratio [HR], 4.5) and OS (HR, 10.8). BRAFV600E was not associated with risk organ involvement or survival. When compared with matched unaffected US population, individuals with LCH had a significantly higher risk of overall mortality (standardized mortality ratio [SMR], 2.66), specifically among those aged <55 years at diagnosis (SMR, 5.94) and those with multisystem disease (SMR, 4.12). Second cancers occurred in 16.4% cases, including diverse hematologic and solid organ malignancies. LCH-associated deaths constituted 36.1% of deaths and occurred within 5 years of diagnosis. After 5 years, non-LCH causes of death, including second cancers, chronic obstructive pulmonary disease, and cardiovascular diseases, predominated. Our study highlights, to our knowledge, for the first time, that adults with LCH experience early and late mortality from non-LCH causes and the need for development of targeted survivorship programs to improve outcomes.
Collapse
Affiliation(s)
- Gaurav Goyal
- Division of Hematology-Oncology, University of Alabama at Birmingham, Birmingham, AL
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | | | - Chen Dai
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL
| | | | - Robert Vassallo
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - Jay H. Ryu
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | | | | | | | | | | | | | | | | | | | - Lucinda M. Gruber
- Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, MN
| | - Surendra Dasari
- Division of Biomedical Statistics and Informatics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Karen L. Rech
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Ronald S. Go
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Mayo Clinic-University of Alabama at Birmingham Histiocytosis Working Group
- Division of Hematology-Oncology, University of Alabama at Birmingham, Birmingham, AL
- Division of Hematology, Mayo Clinic, Rochester, MN
- Department of Internal Medicine, Mayo Clinic, Rochester, MN
- Division of Hematology, Mayo Clinic, Rochester, MN
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL
- Department of Pathology, University of Alabama at Birmingham, Birmingham AL
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
- Department of Radiology, Mayo Clinic, Jacksonville, FL
- Department of Radiology, Mayo Clinic, Rochester, MN
- Department of Neurology, Mayo Clinic, Rochester, MN
- Division of Rheumatology, Mayo Clinic, Rochester, MN
- Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, MN
- Division of Biomedical Statistics and Informatics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| |
Collapse
|
7
|
Acosta-Medina AA, Kemps PG, Zondag TCE, Abeykoon JP, Forma-Borst J, Steenwijk EC, Feijen EAM, Teepen JC, Bennani NN, Schram SM, Shah MV, Davidge-Pitts C, Koster MJ, Ryu JH, Vassallo R, Tobin WO, Young JR, Dasari S, Rech K, Ravindran A, Cleven AHG, Verdijk RM, van Noesel CJM, Balgobind BV, Bouma GJ, Saeed P, Bramer JAM, de Groen RAL, Vermaat JSP, van de Sande MAJ, Smit EF, Langerak AW, van Wezel T, Tonino SH, van den Bos C, van Laar JAM, Go RS, Goyal G, van Halteren AGS. BRAF V600E is associated with higher incidence of second cancers in adults with Langerhans cell histiocytosis. Blood 2023; 142:1570-1575. [PMID: 37595284 PMCID: PMC10797504 DOI: 10.1182/blood.2023021212] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/05/2023] [Accepted: 07/27/2023] [Indexed: 08/20/2023] Open
Abstract
In this retrospective study, BRAF mutation status did not correlate with disease extent or (event-free) survival in 156 adults with Langerhans cell histiocytosis. BRAFV600E was associated with an increased incidence of second malignancies, often comprising hematological cancers, which may be clonally related.
Collapse
Affiliation(s)
- Aldo A. Acosta-Medina
- Department of Internal Medicine, Mayo Clinic, Rochester, MN
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Paul G. Kemps
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Timo C. E. Zondag
- Section Clinical Immunology, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Jelske Forma-Borst
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Eline C. Steenwijk
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Jop C. Teepen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | | | | | | | | | - Jay H. Ryu
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - Robert Vassallo
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | | | | | - Surendra Dasari
- Division of Biomedical Statistics and Informatics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Karen Rech
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Aishwarya Ravindran
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - Arjen H. G. Cleven
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Pathology, University Medical Center Groningen, Groningen, The Netherlands
| | - Robert M. Verdijk
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Carel J. M. van Noesel
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Brian V. Balgobind
- Department of Radiation Oncology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Gerrit Joan Bouma
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Peerooz Saeed
- Department of Ophthalmology, Orbital Center, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jos A. M. Bramer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Ruben A. L. de Groen
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Joost S. P. Vermaat
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michiel A. J. van de Sande
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Orthopedic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Egbert F. Smit
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Anton W. Langerak
- Department of Immunology, Laboratory Medical Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Tom van Wezel
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sanne H. Tonino
- Department of Hematology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Cor van den Bos
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children’s Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jan A. M. van Laar
- Section Clinical Immunology, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
- Section Clinical Immunology, Department of Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ronald S. Go
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Gaurav Goyal
- Division of Hematology, Mayo Clinic, Rochester, MN
- Division of Hematology-Oncology, University of Alabama at Birmingham, Birmingham, AL
| | - Astrid G. S. van Halteren
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Section Clinical Immunology, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| |
Collapse
|
8
|
Lehrnbecher T, Ahlmann M, Albert M, Barnbrock AE, Beutel K, Bochennek K, Classen CF, Holzhauer S, Hutter C, Lakatos K, Meisel R, Porto L, Vokuhl C, Vraetz T, Minkov M. [Updated AWMF Guideline on the Diagnosis and Treatment of Langerhans cell Histiocytosis in Children and Adolescents]. KLINISCHE PADIATRIE 2023; 235:322-330. [PMID: 37666270 DOI: 10.1055/a-2135-3175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
Langerhans cell Histiocytosis is a rare neoplastic disease, which occurs mainly in children and adolescents. The disease may affect any organ, and therefore, the clinical symptoms vary widely. Some patients have a spontaneous remission of the disease, whereas others experience a rapid and potentially lethal clinical course. The therapeutic approach depends on the extent of the disease, and reaches from a watch-and-wait strategy to chemotherapy with the standard drugs vinblastine and prednisone. The identification of mutations in the MAPK-pathway resulted in growing interest in targeted therapy using compounds such as the BRAF inhibitors. Chronic relapses and permanent sequelae are important problems of LCH and are the focus of current research.
Collapse
Affiliation(s)
- Thomas Lehrnbecher
- Pädiatrische Hämatologie, Onkologie und Hämostaseologie, Klinik für Kinder- und Jugendmedizin, Goethe-Universität, Frankfurt, Germany
| | - Martina Ahlmann
- Pädiatrische Hämatologie und Onkologie, Universitätsklinikum Münster, Munster, Germany
| | - Michael Albert
- Dr. von Haunerschen Kinderspital, Ludwig-Maximilians-Universität München Medizinische Fakultät, Munchen, Germany
| | - Anke Elisabeth Barnbrock
- Pädiatrische Hämatologie, Onkologie und Hämostaseologie, Klinik für Kinder- und Jugendmedizin, Goethe-Universität, Frankfurt, Germany
| | - Karin Beutel
- Kinderklinik München-Schwabing, Städtische Kliniken München, München, Germany
| | - Konrad Bochennek
- Pädiatrische Hämatologie, Onkologie und Hämostaseologie, Klinik für Kinder- und Jugendmedizin, Goethe-Universität, Frankfurt, Germany
| | | | - Susanne Holzhauer
- Pädiatrische Hämatologie und Onkologie, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Caroline Hutter
- Children's Cancer Research Institute, St Anna Kinderkrebsforschung, Medizinische Universität Wien, Wien, Austria
| | - Karoly Lakatos
- Children's Cancer Research Institute, St Anna Kinderkrebsforschung, Medizinische Universität Wien, Wien, Austria
| | - Roland Meisel
- Klinik für Kinder-Onkologie, -Hämatologie und Klinische Immunologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Luciana Porto
- Pädiatrische Neuroradiologie, Goethe-Universitat Frankfurt am Main Fachbereich 16 Medizin, Frankfurt am Main, Germany
| | | | - Thomas Vraetz
- Pädiatrische Hämatologie und Onkologie, Universität Freiburg Abteilung Medizin, Freiburg, Germany
| | - Milen Minkov
- Children's Cancer Research Institute, St Anna Kinderkrebsforschung, Medizinische Universität Wien, Wien, Austria
| |
Collapse
|
9
|
AlMadan NM, Sulaiman SM, Almayouf F, Alwhabi M, Alquwayz T. A Case of a Coexisting Carcinosarcoma Ex Pleomorphic Adenoma With Langerhans Cell Histiocytosis in the Parotid Gland. Cureus 2023; 15:e42351. [PMID: 37621779 PMCID: PMC10445182 DOI: 10.7759/cureus.42351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
Carcinosarcoma ex pleomorphic adenoma is a rare malignant neoplasm, with most cases reported in the parotid gland. We herein report a case of a 75-year-old male referred to our hospital with a long-standing right parotid lesion that was treated in an outside hospital by a superficial parotidectomy. The patient reported a painful, rapidly enlarging mass following the excision. Histopathological examination showed the proliferation of malignant epithelial and mesenchymal elements with a solid sheet of Langerhans cells admixed with eosinophils. The Langerhans cells were reactive to CD1a and BRAF; hence, a diagnosis of carcinosarcoma ex pleomorphic adenoma with Langerhans cell histiocytosis was given. Complete clinical and radiographic workup showed no other organ involvement. The patient underwent total parotidectomy with adjuvant chemoradiation; however, the tumor progressed and showed lung metastasis. We herein report the first case of a concurrent Langerhans cell histiocytosis with associated carcinosarcoma ex pleomorphic adenoma.
Collapse
Affiliation(s)
| | | | - Furat Almayouf
- Anatomic Pathology, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Mohammed Alwhabi
- Anatomic Pathology, Prince Sultan Military Medical City, Riyadh, SAU
| | - Turki Alquwayz
- Dentistry, King Salman Armed Forces Hospital, Tabuk, SAU
| |
Collapse
|
10
|
Hyrcza MD, Lindenmuth TR, Auerbach A. Top Ten Lymphoproliferative Lesions Not to Miss When Evaluating Oral Ulcer Biopsies. Head Neck Pathol 2023; 17:99-118. [PMID: 36928739 PMCID: PMC10063747 DOI: 10.1007/s12105-023-01532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/12/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Oral ulcers represent a full thickness loss of the mucosal epithelium leading to exposure of the submucosal connective tissue. These are common and usually self-limited lesions, although they may sometimes result from neoplasms, most commonly squamous cell carcinoma. Lymphoproliferative disorders may be difficult to diagnose in apthous ulcers since they mimic reactive inflammation. METHODS This review presents ten rare oral lymphoid proliferations which should not be missed when assessing oral ulcer biopsies. RESULTS The ten lesions include several with diagnostic cells which look similar to the histiocytes of a reactive inflammatory ulcer, including Rosai-Dorfman disease, reticulohistiocytoma, Langerhans cell histiocytosis, and traumatic ulcerative granuloma. Other lesions, such as EBV-positive mucocutaneous ulcer, extranodal marginal zone lymphoma of mucosal-associated lymphoid tissue, and plasmablastic lymphoma have lymphoid and/or plasma cell differentiation that mimic the reactive lymphocytes and plasma cells found in reactive ulcers. Two dendritic cell lesions, follicular dendritic cell sarcoma and blastic plasmacytoid dendritic cell neoplasm, both have distinct phenotypes which are required to make an accurate diagnosis. CONCLUSION Each of these lesions are diagnosed by evaluating their histology, along with their phenotypic profile, which is sometimes enhanced by pertinent molecular findings.
Collapse
Affiliation(s)
- Martin D. Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Arnie Charbonneau Cancer Institute, Calgary, AB Canada
| | | | | |
Collapse
|
11
|
Burtsev EA, Bronin GO. Langerhans Cell Histiocytosis in Children: Literature Review. CURRENT PEDIATRICS 2023. [DOI: 10.15690/vsp.v22i1.2520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Relevant information on Langerhans cell histiocytosis development and course in children is presented. The current concepts of disease pathogenesis, principles of its severity evaluation, patients stratification into risk groups, as well as of clinical course features are described. Modern approaches to the disease treatment via targeted therapy are summarized and analyzed.
Collapse
|
12
|
Joseph NM, Wen KW. Incidental Langerhans cell histiocytosis associated with metastatic neuroendocrine tumor in the adult liver. Clin Case Rep 2023; 11:e6922. [PMID: 36789329 PMCID: PMC9909255 DOI: 10.1002/ccr3.6922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/06/2022] [Accepted: 01/03/2023] [Indexed: 02/11/2023] Open
Abstract
This is an unusual adult case of a metastatic well-differentiated neuroendocrine tumor with incidentally discovered subtle involvement of Langerhans cell histiocytosis (LCH), a clonal proliferation of Langerhans cells. It is important to recognize that LCH can often co-exist with other malignancies (solid > hematologic).
Collapse
Affiliation(s)
- Nancy M. Joseph
- Department of PathologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Kwun Wah Wen
- Department of PathologyUniversity of CaliforniaSan FranciscoCaliforniaUSA,Helen Diller Family Comprehensive Cancer CenterUniversity of CaliforniaSan FranciscoCaliforniaUSA
| |
Collapse
|