Case 4

28y/F , presented B/L cervical lymphnodes of 1 – 4cm. in size of 6months duration. FNA of lymphnodes done

Cytology: Cellular smear,

Lymphoid cells, histiocytes/macrophages,

A few large cells with mono/binucleate, with prominent nucleoli, ?RS cells

Numerous eosinophils, occ. Plasma cells

DIAGNOSIS

Case 4

1. Histoplasmosis, Kimura’s Disease2. Lymphoproliferative Diease3. HD – Mixed Cellularaity4. LCH5. HD – Lypmphocytic Predominance6. SHML with Eo7. SHML with LCH8. Kimura’s disease

IMP: Positive Malignancy – 1. Malignant lymphoma, HD/ALCL 2. Metastatic Undifferentiated Carcinoma Case will be reviewed after H & N workup H & N workup was normal FINAL IMP: 1. Malignant lymphoma, HD/ALCL 2. Histiocytic Lesion Advised LN Bx and IHC study

CD1a

S100

CD30

CD15

CD30

CD15

Final diagnosis

Hodgkin Lymphoma-syncial type with LCH

Diagnosis of Hodgkin Lymphoma

Diagnosis of LCH

LCH – Systemic or single organ disease lung, bone, lymphnode, skin, etc.

Cytology findings

Histomorphology –sinusoidal pattern + IHC

LCH+Lymphoma – Focal Langerhan Cell Histiocytic Hyperplasia rather than LCH

J Res Med Sci. 2010 Jan-Feb; 15(1): 58–61.

Langerhans cell histiocytosis following Hodgkin lymphoma: a case report from IranNahid Reisi Dehkordi,a Parvin Rajabi,b Azar Naimi,*,c and Mitra Heidarpourd

Occurrence of LCH after Hodgkin lymphoma is seen in less than 0.3% of cases. It can occur before, after or simultaneously with Hodgkin Lymphoma.

Korean J Intern Med. Dec 2012; 27(4): 459–462.

Langerhans Cell Histiocytosis Followed by Hodgkin's LymphomaIK Soo Park,1 In Keun Park,1 Eun Kyoung Kim,1 Shin Kim,1 Sang Ryong Jeon,2 Joo Ryung Huh,3 and Cheol Won Suh 1

This condition should be considered in the differential diagnosis of recurrent lymphoma

Thank

you