Ldr. Thompson et al., LANGERHANS CELL HISTIOCYTOSIS OF THE THYROID - A SERIES OF 7 CASES AND A REVIEW OF THE LITERATURE, Modern pathology, 9(2), 1996, pp. 145-149
Langerhans cell histiocytosis is a rare disorder, with a few reports d
escribing isolated thyroid gland involvement. We report seven cases, w
hich included four females and three males ranging in age from 2 month
s to 55 years, with a median age of 37 years. Histologically, the case
s demonstrated either diffuse or focal involvement of the thyroid glan
d by Langerhans cell histiocytes, characterized by bean-shaped, lobate
d, folded nuclei. In association with the histiocytic infiltrate, ther
e was a prominent eosinophilic cellular component, as well as destruct
ion of the thyroid follicles. All cases occurred in a background of ly
mphocytic thyroiditis. One case demonstrated adenomatoid nodules, wher
eas another had a microscopic papillary carcinoma. Immunohistochemical
staining demonstrated positive reactivity with S-100 protein, lysozym
e, and KP-1. Four patients with isolated thyroid disease, treated by s
urgical resection alone, are alive without systemic disease from 3 to
19 years after initial presentation. The three patients with systemic
disease died within 1 year of the initial diagnosis with disease-relat
ed complications. Localized disease portends a favorable prognosis as
compared to the thyroid involvement as part of systemic disease.