Sahoo M, Karak A K, Bhatnagar D, Bal C S
Department of Cytopathology, Institute of Nuclear Medicine and Allied Sciences, Timarpur, India.
Diagn Cytopathol. 1998 Jul 1;19(1):33-7. doi: 10.1002/(sici)1097-0339(199807)19:1<33::aid-dc7>3.0.co;2-p.
We present an unusual case of isolated thyroid involvement with Langerhans cell histiocytosis (LCH), diagnosed presumptively by fine-needle aspiration (FNA) cytology and subsequently confirmed by immunohistochemistry in a 13-yr-old boy. The cytologic findings include high cellularity in a hemorrhagic background, the presence of characteristic mononucleated and multinucleated Langerhans cells with prominent nuclear grooves, and abundant foamy cytoplasm in a background of mixed eosinophilic and aggregates of benign thyroid follicular cells. Further diagnostic confirmation was obtained by positive S-100 protein immunohistochemistry of the Langerhans histiocytes on paraffin-embedded sections of open thyroid biopsy of the prominently enlarged left lobe. We present the complete clinicopathologic features of this case, along with ultrasound, computerized axial tomographic, and technetium-99 scan findings. We also discuss possible differential diagnostic consideration in light of a review of the literature and the role of FNA cytologic diagnosis in such a rare yet cytomorphologically characteristic case.
我们报告了一例罕见的仅累及甲状腺的朗格汉斯细胞组织细胞增多症（LCH）病例，该病例发生在一名13岁男孩身上，最初通过细针穿刺（FNA）细胞学检查进行初步诊断，随后通过免疫组织化学得以确诊。细胞学检查结果包括：出血背景下细胞丰富，存在具有明显核沟的特征性单核和多核朗格汉斯细胞，以及在混合嗜酸性细胞和良性甲状腺滤泡细胞聚集体背景下的丰富泡沫状细胞质。通过对显著增大的左叶甲状腺开放活检石蜡包埋切片上的朗格汉斯组织细胞进行S-100蛋白免疫组织化学检测，进一步获得了诊断证实。我们展示了该病例完整的临床病理特征，以及超声、计算机断层扫描和锝-99扫描结果。我们还结合文献回顾讨论了可能的鉴别诊断考虑因素，以及FNA细胞学诊断在这种罕见但具有细胞形态学特征的病例中的作用。
