title: A case of Langerhans' cell histiocytosis associated with Hodgkin's lymphoma: Fine-needle aspiration cytologic and histopathological features.
abstract: Langerhans cell histiocytosis (LCH) can be associated with a variety of malignant neoplasms, the most common being malignant lymphoma, especially Hodgkin's lymphoma (HL). In this report, we describe the fine needle aspiration (FNA) cytologic features of a case with concurrent LCH and HL in a lymph node. A 20-year-old man presented with an enlarged left upper cervical lymph node. FNA smears from the swelling revealed numerous CD1a+ and S-100+ Langerhans-type cells (LCs) along with many eosinophils, neutrophils, and lymphocytes; there were also large atypical cells with enlarged nuclei having prominent nucleoli. The cytodiagnosis was LCH and the possibility of association with or trans-differentiation into a lymphoma was suggested. The histopathological diagnosis of the excised left cervical lymph node was classical HL-nodular sclerosis type (CHL-NS) with LCH. The lacunar type Reed-Sternberg (RS) cells were positive for CD30 and CD15, and the LCs were positive for CD1a and S-100 protein. PET/CT imaging demonstrated hypermetabolic lymph nodes in neck, abdomen, thorax and pelvis as well as pulmonary nodules and a splenic mass. The patient received 13 courses of chemotherapy and two years later, the enhanced CT revealed regressive course of the disease.
authors.affiliation: Department of Pathology, Faculty of Medicine, Kuwait University, Safat, Kuwait.|Mubarak Al-Kabeer Hospital, Cytology Unit, Jabriya, Kuwait.
authors.forename: Dilip K
authors.initials: DK
authors.lastname: Das
authors.affiliation: Mubarak Al-Kabeer Hospital, Cytology Unit, Jabriya, Kuwait.
authors.forename: Zafar A
authors.initials: ZA
authors.lastname: Sheikh
authors.affiliation: Mubarak Al-Kabeer Hospital, Cytology Unit, Jabriya, Kuwait.
authors.forename: Taiba A
authors.initials: TA
authors.lastname: Alansary
authors.affiliation: Hussain Makki Al-Juma Center for Specialized Surgery, Kuwait.
authors.forename: Thasneem
authors.initials: T
authors.lastname: Amir
authors.affiliation: Mubarak Al-Kabeer Hospital, Histopathology Unit, Kuwait.
authors.forename: Fatma N
authors.initials: FN
authors.lastname: Al-Rabiy
authors.affiliation: Mubarak Al-Kabeer Hospital, Histopathology Unit, Kuwait.
authors.forename: Thamradeen A
authors.initials: TA
authors.lastname: Junaid
mesh_terms: D044963:Biopsy, Fine-Needle; D001773:Blood Cells / Q000473:pathology; D006646:Histiocytosis, Langerhans-Cell / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D006689:Hodgkin Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007515:Islets of Langerhans / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D011877:Radionuclide Imaging; D055815:Young Adult
keywords: Hodgkin's lymphoma; Langerhans cell histiocytosis; fine needle aspiration cytology; immunohistochemistry; lymph nodes