Isolated Langerhans Cell Histiocytosis of the Thyroid: A very rare case report

Abstract

Langerhans cell histiocytosis (LCH) is a group of diseases that cause damage by local or widespread accumulation of atypical histiocytes in various tissues such as skin, bone, lung, liver, lymph nodes, mucocutaneous tissues, and endocrine organs. LCH was detected as a result of a total thyroidectomy biopsy performed on a 43-year-old female patient with a solitary euthyroid nodule following weight loss and an increase in the size of the thyroid nodule during outpatient clinic checks. Patient's whole body positron emission tomography. The case of LCH with isolated thyroid involvement is very rare, and a limited number of cases have been presented on this subject. In addition, it will contribute to the literature since there are fewer than ten LCH cases with thyroid involvement.

Keywords

• Langerhans cell histiocytosis
• fine needle aspiration biopsy
• thyroid

References

1. Patten DK, Wani Z, Tolley N. Solitary langerhans histiocytosis of the thyroid gland: a case report and literature review. Head Neck Pathol. 2012 Jun;6(2):279-89. doi: 10.1007/s12105-011-0321-8.
2. Elliott DD, Sellin R, Egger JF, Medeiros LJ. Langerhans cell histiocytosis presenting as a thyroid gland mass. Ann Diagn Pathol. 2005 Oct;9(5):267-74. doi: 10.1016/j.anndiagpath.2005.05.002.
3. Zhang J, Wang C, Lin C, Bai B, Ye M, Xiang D, Li Z. Spontaneous thyroid hemorrhage caused by Langerhans cell histiocytosis: A case report and literature review. Front Endocrinol (Lausanne). 2021 May 19;12:610573. doi: 10.3389/fendo.2021.610573.
4. Broadbent V, Egeler RM, Nesbit ME Jr. Langerhans cell histiocytosis--clinical and epidemiological aspects. Br J Cancer Suppl. 1994 Sep;23:S11-6.
5. Ceyran AB, Senol S, Bayraktar B, Ozkanlı S, Cinel ZL, Aydın A. Langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying metastatic thyroid papillary carcinoma. Case Rep Pathol. 2014;2014:184237. doi: 10.1155/2014/184237.
6. Allen CE, Merad M, McClain KL. Langerhans-cell histiocytosis. N Engl J Med. 2018 Aug 30;379(9):856-68. doi: 10.1056/NEJMra1607548.
7. Pandyaraj RA, Sathik Mohamed Masoodu K, Maniselvi S, Savitha S, Divya Devi H. Langerhans cell histiocytosis of thyroid-a diagnostic dilemma. Indian J Surg. 2015 Apr;77(Suppl 1):49-51. doi: 10.1007/s12262-014-1118-2.
8. Lin CH, Lin WC, Chiang IP, Ho YJ, Peng CT, Wu KH. Langerhans cell histiocytosis with thyroid and lung involvement in a child: a case report. J Pediatr Hematol Oncol. 2010 May;32(4):309-11. doi: 10.1097/MPH.0b013e3181c4de1a.

9. Pusztaszeri MP, Sauder KJ, Cibas ES, Faquin WC. Fine-needle aspiration of primary Langerhans cell histiocytosis of the thyroid gland, a potential mimic of papillary thyroid carcinoma. Acta Cytol. 2013;57(4):406-12. doi: 10.1159/000348801.
10. Jezierska M, Stefanowicz J, Romanowicz G, Kosiak W, Lange M. Langerhans cell histiocytosis in children - a disease with many faces. Recent advances in pathogenesis, diagnostic examinations and treatment. Postepy Dermatol Alergol. 2018 Feb;35(1):6-17. doi: 10.5114/pdia.2017.67095.
11. Dehner LP. Juvenile xanthogranulomas in the first two decades of life: a clinicopathologic study of 174 cases with cutaneous and extracutaneous manifestations. Am J Surg Pathol. 2003 May;27(5):579-93. doi: 10.1097/00000478-200305000-00003.
12. Cavalli G, Guglielmi B, Berti A, Campochiaro C, Sabbadini MG, Dagna L. The multifaceted clinical presentations and manifestations of Erdheim-Chester disease: comprehensive review of the literature and of 10 new cases. Ann Rheum Dis. 2013 Oct;72(10):1691-5. doi: 10.1136/annrheumdis-2012-202542.
13. Goyal G, Tazi A, Go RS, Rech KL, Picarsic JL, Vassallo R, Young JR, Cox CW, Van Laar J, Hermiston ML, Cao XX, Makras P, Kaltsas G, Haroche J, Collin M, McClain KL, Diamond EL, Girschikofsky M. International expert consensus recommendations for the diagnosis and treatment of Langerhans cell histiocytosis in adults. Blood. 2022 Apr 28;139(17):2601-21. doi: 10.1182/blood.2021014343.
14. Donadieu J, Larabi IA, Tardieu M, Visser J, Hutter C, Sieni E, Kabbara N, Barkaoui M, Miron J, Chalard F, Milne P, Haroche J, Cohen F, Hélias-Rodzewicz Z, Simon N, Jehanne M, Kolenova A, Pagnier A, Aladjidi N, Schneider P, Plat G, Lutun A, Sonntagbauer A, Lehrnbecher T, Ferster A, Efremova V, Ahlmann M, Blanc L, Nicholson J, Lambilliote A, Boudiaf H, Lissat A, Svojgr K, Bernard F, Elitzur S, Golan M, Evseev D, Maschan M, Idbaih A, Slater O, Minkov M, Taly V, Collin M, Alvarez JC, Emile JF, Héritier S. Vemurafenib for refractory multisystem Langerhans cell histiocytosis in children: An international observational study. J Clin Oncol. 2019 Nov 1;37(31):2857-65. doi: 10.1200/JCO.19.00456.