Generalized histiocytosis X in the elderly: a light and electron microscope and monoclonal antibody study

Abstract

1984) Histopathology 8, 927-936. Generalized histiocytosis X in the elderly: a light and electron microscope and monoclonal antibody studyTwo elderly female patients are described with generalized histiocytosis X (LettererSiwe disease). In each case, a definitive diagnosis was not established until ultrastructural and immunoperoxidase investigations had been performed. The histopathological findings in skin biopsies from each patient were similar. Light microscopy demonstrated a bandlike epidermotrophic cellular infiltrate which included large atypical cells (histiocytosis X cells). Electron microscopy showed that these cells contained Birbeck granules. Monoclonal antibody studies demonstrated the presence of T6, T4 and HLA-DR surface antigens. Lysozyme and alpha-1-antitrypsin were absent from the cells. The associated cellular infiltrate included T4 and T8 positive lymphocytes. It is possible that more cases of generalized histiocytosis X in adults will be identified with the increasing use of specialized histopathological techniques and that the disease is more common than currently believed.

Langerhans‐cell histiocytosis confined to the skin of an elderly patient

“…The diagnosis of Langerhans celt histiocytosis includes, as a distinctive pathological feature, the presence of Langerhans cells as components of the lesions. These cells show cytoplasmic staining with S-1()O antigen and other monoclonal or polyclonal antibody stains [2,12,13]. These data justify only a higher level of diagnostic confidence but not "definitive diagnosis'".…”