Abstract
Lymph node involvement in Langerhans cell (LC) histiocytosis (LCH) can be seen as a component of the systemic form, or it may be the initial and sometimes exclusive manifestation of the disease. Descriptions of patients with LCH whose disease is confined to lymph nodes are rare. We present a case of LCH confined to lymph nodes initially diagnosed by fine needle aspiration (FNA) cytology in a 43-year-old male. The cytologic findings in LCH included high cellularity, isolated LCs with prominent nuclear indentations and grooves, multinucleate giant cells, eosinophils and lymphocytes. Confirmation of LCH was obtained by positive S-100 protein immunohistochemical staining and the demonstration of Birbeck granules on electron microscopy. The presence of LCs with prominent nuclear indentations and grooves is characteristic of LCH confined to lymph nodes and serves as a key point in suggesting the diagnosis of LCH.
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