Pulmonary crystal-storing histiocytosis diagnosed by computed tomography-guided fine-needle aspiration.
Crystal-storing histiocytosis (CSH) is a rare process most often occurring in conjunction with an underlying hematopoietic neoplasm, usually multiple myeloma or low-grade B-cell lymphoma. We report the first case of pulmonary CSH diagnosed by fine-needle aspiration biopsy. A patient with a history of urothelial carcinoma developed a lung nodule, which was evaluated by fine-needle aspiration biopsy. Cytologic examination revealed macrophages with abundant cytoplasmic crystals diagnostic of CSH. Based on this cytologic interpretation, additional clinical laboratory evaluation was pursued and revealed a previously unknown monoclonal serum protein. CSH must be differentiated from other non-neoplastic and neoplastic lesions and when diagnosed, should trigger a search for an underlying lymphoproliferative disorder.
Department of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033-0850, USA.
William U
WU
Todd
Joseph J
JJ
Drabick
Michael G
MG
Benninghoff
Elizabeth E
EE
Frauenhoffer
Dani S
DS
Zander
D000368:Aged; D044963:Biopsy, Fine-Needle; D003460:Crystallization; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology*; D049268:Positron-Emission Tomography; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed / Q000379:methods*