Pulmonary Langerhans Cell Histiocytosis: Diagnosis in Bronchoalveolar Lavage Liquid-Based Cytology Samples.

IF 1.6 4区医学 Q3 PATHOLOGY Acta Cytologica Pub Date : 2024-01-01 Epub Date: 2024-07-18 DOI:10.1159/000540011

Anjali Gupta, Parikshaa Gupta, Nalini Gupta, Sahajal Dhooria, Pankaj C Vaidya, Nidhi Prabhakar, Amanjit Bal, Joseph L Mathew

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Abstract

Introduction: Pulmonary Langerhans cell histiocytosis (PLCH) is a rare interstitial lung disease characterized by the accumulation of Langerhans cells within the lung tissue. The diagnosis of PLCH traditionally involves clinical, radiological, and lung biopsy histopathological evaluations.

Case presentation: We present 2 cases where the diagnosis of PLCH was confirmed through the analysis of bronchoalveolar lavage (BAL) fluid cytology using immunoperoxidase technique, highlighting the significance of this minimally invasive technique in the diagnostic process. Clinical and radiological examination suggested advanced interstitial lung disease characterized by a fibrocystic pattern in both cases. The cytologic analysis of the BAL fluid revealed typical histiocytes with longitudinal grooves and eosinophils, which was better seen on liquid-based cytology (LBC) smears. ICC with CD1a, Langerin, and S-100 confirmed the diagnosis of PLCH.

Conclusion: Detecting PLCH through the examination of BAL cytology poses challenges, yet it is achievable, particularly with the assistance of LBC and ICC.

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肺朗格汉斯细胞组织细胞增生症：基于支气管肺泡灌洗液的细胞学样本诊断。

简介肺朗格汉斯细胞组织细胞增生症（PLCH）是一种罕见的间质性肺病，其特征是肺组织内朗格汉斯细胞的聚集。传统上，PLCH 的诊断包括临床、放射学和肺活检组织病理学评估：我们介绍了两例利用免疫过氧化物酶技术对支气管肺泡灌洗液（BAL）细胞学进行分析从而确诊为 PLCH 的病例，强调了这种微创技术在诊断过程中的重要性。临床和放射学检查显示，两例患者均为晚期间质性肺病，其特征为纤维囊肿。BAL 液的细胞学分析显示，典型的组织细胞带有纵沟和嗜酸性粒细胞，这在液基细胞学（LBC）涂片上表现得更为明显。用 CD1a、Langerin 和 S-100 检测 ICC，确诊为 PLCH：结论：通过 BAL 细胞学检查检测 PLCH 是一项挑战，但这是可以实现的，尤其是在 LBC 和 ICC 的帮助下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Cytologica 生物-病理学

CiteScore

3.70

自引率

11.10%

发文量

审稿时长

4-8 weeks

期刊介绍： With articles offering an excellent balance between clinical cytology and cytopathology, ''Acta Cytologica'' fosters the understanding of the pathogenetic mechanisms behind cytomorphology and thus facilitates the translation of frontline research into clinical practice. As the official journal of the International Academy of Cytology and affiliated to over 50 national cytology societies around the world, ''Acta Cytologica'' evaluates new and existing diagnostic applications of scientific advances as well as their clinical correlations. Original papers, review articles, meta-analyses, novel insights from clinical practice, and letters to the editor cover topics from diagnostic cytopathology, gynecologic and non-gynecologic cytopathology to fine needle aspiration, molecular techniques and their diagnostic applications. As the perfect reference for practical use, ''Acta Cytologica'' addresses a multidisciplinary audience practicing clinical cytopathology, cell biology, oncology, interventional radiology, otorhinolaryngology, gastroenterology, urology, pulmonology and preventive medicine.