Langerhans cell histiocytosis
Langerhans cell histiocytosis
Updated: 06/16/2025
© Jun Wang, MD, PhD
General features
- Idiopathic
- Likely neoplastic
Clinical presentations
- Commonly eczematous skin rash, lytic bone lesions or otitis media
- Tumor like lesions
- Nodal or extranodal
Key risk factors
- Smoking for pulmonary lesions
Key pathogenesis
- Activating BRAF mutation
Key morphological features
- Partial effacement of lymph node
- Solid infiltration of Langerhan cells distending sinus
- Langerhan cells: Elongated nuclei with nuclear grooves/folds
- Birbeck granules: Electron microscopic finding, elongated zipperlike cytoplasmic structure, double outer sheath
Genetic abnormalities
- Activating BRAF mutation
Markers
- Positive: S-100, CD1a
- Wide spread type: Letterer-Siwe disease
- Extreme age
- Lung involvement
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