Childhood pulmonary langerhans cell histiocytosis in bronchoalveolar lavage: A case report along with review of literature

Isolated pulmonary Langerhans cell histiocytosis (LCH) is rare in childhood, and few cases have been diagnosed on bronchoalveolar lavage (BAL) smears. We hereby report a child with cystic lesions in both lungs diagnosed as LCH on BAL smears and compare the cytomorphologic findings with BAL smears of...

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Bibliographic Details
Published in:Diagnostic cytopathology 2016-12, Vol.44 (12), p.1102-1106
Main Authors: Sharma, Sudha, Dey, Pranab
Format: Article
Language:English
Subjects:
Adult
Bronchoalveolar Lavage
bronchoalveolar lavage (BAL)
CD1a
Cell Nucleus - pathology
Child
Female
Giant Cells - pathology
Histiocytes - pathology
Histiocytosis, Langerhans-Cell - pathology
Humans
Macrophages - pathology
Male
Middle Aged
Pleural Effusion - pathology
pulmonary Langerhans cell histiocytosis (PLCH)
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Summary:Isolated pulmonary Langerhans cell histiocytosis (LCH) is rare in childhood, and few cases have been diagnosed on bronchoalveolar lavage (BAL) smears. We hereby report a child with cystic lesions in both lungs diagnosed as LCH on BAL smears and compare the cytomorphologic findings with BAL smears of five patients with various pathologies. The BAL smears of the index case showed numerous macrophages with many atypical histiocytes showing coffee bean‐shaped nuclei, nuclear grooving along with few giant cells. Immunocytochemistry for S‐100 protein and CD1a was positive in these cells (16.5%). The mean percentage of macrophages showing nuclear grooving, bi‐nucleation, and multinucleation was much higher in the case with LCH compared to the other cases. Review of literature and the present case study shows that in the presence of appropriate radiologic findings, characteristic morphologic features and demonstration of 5% or more CD1a positive cells in BAL is strongly suggestive of pulmonary LCH. Diagn. Cytopathol. 2016;44:1102–1106. © 2016 Wiley Periodicals, Inc.
ISSN:8755-1039
1097-0339
DOI:10.1002/dc.23561