Concurrent Langerhans Cell Histiocytosis and B-Lineage Lymphoid Proliferation in the Bone Marrow.
10.3343/kjlm.2009.29.5.402
- Author:
Miyoung KIM
1
;
Hyoung Jin KANG
;
Hee Young SHIN
;
Hyo Seop AHN
;
Dong Soon LEE
Author Information
1. Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea. soonlee@snu.ac.kr
- Publication Type:Case Report
- Keywords:
Langerhans cell histiocytosis;
Lymphoid proliferation;
Bone marrow
- MeSH:
Antineoplastic Agents/therapeutic use;
B-Lymphocytes/immunology/*pathology;
Bone Marrow/immunology/*pathology;
Cell Proliferation;
Child;
Child, Preschool;
Cyclophosphamide/therapeutic use;
Drug Therapy, Combination;
Female;
Histiocytosis, Langerhans-Cell/*diagnosis/drug therapy/pathology;
Humans;
Male;
Methotrexate/therapeutic use;
Prednisone/therapeutic use;
Vinblastine/therapeutic use
- From:The Korean Journal of Laboratory Medicine
2009;29(5):402-405
- CountryRepublic of Korea
- Language:English
-
Abstract:
We present three cases of concurrent Langerhans cell histiocytosis (LCH) and B-lineage lymphoid cell infiltrations and/or nodules in the bone marrow. The first patient was a 25-month-old boy who presented with LCH on the right shoulder and multiple osteolytic lesions. Bone marrow biopsy showed the presence of LCH and two large lymphoid nodules of B-lineage, which were located in the paratrabecular region. Both LCH and the lymphoid nodules resolved after treatment with prednisone, vinblastine, methotrexate, and cyclophosphamide. The second patient was a 7-month-old girl who presented with LCH in the scalp and bone marrow. In spite of the treatment, a follow-up bone marrow analysis performed after 16 months showed LCH and increased B-lineage lymphoid cells in the interstitial area. The third patient was a 26-month-old girl, and imaging studies revealed reddish skin lesions and multiple osteolytic lesions. Skin biopsy and bone marrow biopsy did not show the presence of LCH; however, we initiated the treatment on the basis of the results of imaging studies. The follow-up study after 6 months showed the presence of LCH and large, patchy infiltration of B-lymphoid cells. We report three rare cases of concurrent bone marrow involvement of LCH and B-lineage lymphoid proliferation, which strongly suggest lymphoid malignancy. Further, clonal changes should be studied to elucidate the common pathogenic mechanism between the two diseases.
