LANGERHANS' CELL HISTIOCYTOSIS (HISTIOCYTOSIS X)


This biopsy is from one of many papules that developed on a seven month old male. This was not from the breast or genital region.

A discussion of Langerhans' cell histocytosis can be found in dermatology and dermatopathology text books. This case is presented to emphasize the large size of the abnormal histiocytes, the characteristic nuclear features, and the importance of clinical and additional immunoperoxidase information to distinguish the pagetoid S100 positive cells from the melanocytes of superficial spreading melanoma. Extrmammary or mammary Paget's disease are also in the histologic differential diagnosis.

 Low power view showing an epidermotropic infiltrate  that is most prominent in the left side of the picture. There is an infiltrate of similar cells in the papillary dermis in the right side of the picture.

High power view showing large epidermotropic cells having eccentrically placed, large reniform nuclei.

S100 immunoperoxidase preparation.

CD1a immunoperoxidase preparation.

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