Lesions resembling Langerhans cell histiocytosis in association with other lymphoproliferative disorders: a reactive or neoplastic phenomenon?

Lesley J. Christie, Alan T. Evans, Susan E. Bray, Mark E. F. Smith, Neil M. Kernohan, David A. Levison, John R. Goodlad

    Research output: Contribution to journalArticlepeer-review

    61 Citations (Scopus)

    Abstract

    Langerhans cell histiocytosis (LCH) has been described in association with a variety of neoplasms preceding, after, or synchronous with the other tumor. In some cases, a neoplasm may arise as a complication of therapy for LCH, and in others, the association may be coincidental. Synchronous occurrence has been reported most commonly in association with malignant lymphoma in which discrete proliferations of Langerhans cells (LCs) histologically indistinguishable from LCH are seen. In most cases, these LCs are closely related to or intermingling with the primary pathology. The nature of LCs in this context remains elusive with debate as to whether they represent a true clonal neoplasm or an exaggerated reactive phenomenon. The lack of evidence for LCH progression or disease elsewhere strongly supports the latter. We have encountered 5 examples of LCH-like proliferations occurring in the context of other lymphoproliferative disorders. These include 2 cases of mycosis fungoides and 1 of cutaneous B-cell pseudolymphoma, associations that to our knowledge have not been described before. Two patients were female, and the clonality of the LC proliferation was assessed using laser capture microdissection and the human androgen receptor. The results showed that the LCs forming discrete nodules in a case of cutaneous B-cell pseudolymphoma and a case of Hodgkin's lymphoma were polyclonal. This suggests that, at least in a proportion of cases, the aggregates of LCs occasionally identified within other lymphoproliferative lesions represent a reactive proliferation rather than a potentially aggressive second neoplasm.
    Original languageEnglish
    Pages (from-to)32-39
    Number of pages8
    JournalHuman Pathology
    Volume37
    Issue number1
    DOIs
    Publication statusPublished - Jan 2006

    Keywords

    • Langerhans cell histiocytosis
    • Clonal analysis
    • Lymphoproliferative disorders
    • HUMARA
    • Reactive Langerhans cell proliferation
    • Human androgen receptor assay (HUMARA)

    Fingerprint Dive into the research topics of 'Lesions resembling Langerhans cell histiocytosis in association with other lymphoproliferative disorders: a reactive or neoplastic phenomenon?'. Together they form a unique fingerprint.

    Cite this