Cytological Diagnosis May Prevent Invasive Biopsy in Patients With Langerhans Cell Histiocytosis

Langerhans cell histiocytosis (LCH) is difficult to diagnose because it is so rare; however, an assessment of a large cohort of cases identified cytomorphological features that can facilitate a timely diagnosis and potentially avoid the need for an invasive biopsy. The cohort included 47 LCH cases diagnosed using cytological material and fine-needle aspiration (FNA) over a 14-year period (2003-2016). Key cytological findings included the following:

• Most cytological smears (58%) were moderately to highly cellular and contained abundant Langerhans cells (72%).
• 38% of smears revealed areas of necrosis and 78% revealed giant cells.
• Most smears showed mild eosinophilia (61%), sparse lymphocytosis (83%), and mild neutrophilic infiltration (64%).
• There were 1 to 2 mitoses per 10 high power field in 12 cases (25.5%), with no abnormal mitoses identified.

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Reference

Phulware RH, Guleria P, Iyer VK, et al. Cytological diagnosis of Langerhans cell histiocytosis: a series of 47 cases. Cytopathology. 2019 Apr 24. doi: 10.1111/cyt.12709.