Cytology of secondary hemophagocytic lymphohistiocytosis masquerading as lymphoma in a nonimmunocompromised adult

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal immune disorder which is uncommon in a nonimmunocompromised adult. A 27-year-old female who presented with fever, hematuria, generalized lymphadenopathy was clinically suspected to have lymphoma was subjected to fine needle aspiration of cervical lymph nodes. Cytology of lymph node had numerous histiocytes with phagocytosed lymphocytes, red blood cells and nuclear debris. A diagnosis of secondary HLH was made based on cytological findings, clinical manifestations, and laboratory results. She was treated with steroids and recovered completely. A high degree of clinical suspicion coupled with comprehensive cytology with fine needle aspiration cytology is fruitful in the diagnosis of HLH, a potentially fatal disease and help in the delineation of therapeutic regimen.

Role of fine needle aspiration cytology in the diagnosis of juvenile xanthogranuloma in adult: Case report and review of the literature

“…15,16 The cytological diagnosis of HLH is based on the presence of numerous macrophages showing phagocytosis of lymphocytes, erythrocytes, and nuclear debris along with several other laboratory criteria required for establishing the diagnosis. 17 FNA smears of xanthomas are characterized by loosely cohesive sheets of foamy histiocytes along with extracellular lipid (which can be confirmed by oil red O). 18 The histiocytes in Juvenile xanthogranuloma are uniformly positive for vimentin, CD68, and factor XIIIa, and negative for S-100 and CD1a.…”

Cytological diagnosis of juvenile xanthogranuloma: A rare histiocytic disorder

“…The cytological diagnosis of HLH is based on the presence of numerous macrophages showing phagocytosis of lymphocytes, erythrocytes, and nuclear debris along with several other laboratory criteria required for establishing the diagnosis . FNA smears of xanthoms are characterized by loosely cohesive sheets of foamy histiocytes along with extracellular lipid (which can be confirmed by oil red O) …”