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A rare case of langerhans cell histiocytosis of the gastrointestinal tract

World Journal of Gastroenterology 2012年第12期18卷 1410-1413页

作者： Uday Shankar Monika Prasad Om P Chaurasia Internal Medicine Mount Sinai School of Medicine at Queens Hospital CenterJamaicaNY 11432United States Department of Medicine University of CaliforniaIrvineCA 92697United States

langerhans cell histiocytosis （LCH） is a group of idiopathic disorders characterized by the proliferation of specialized, bone marrow-derived langerhans cells and mature eosinophils. The clinical spectrum ranges from an acute, fulminant, disseminated disease called Letterer Siwe disease to solitary or few, indolent and chronic lesions of the bone or other organs called eosinophilic granuloma. Involvement of the gastrointestinal tract is very rare in LCH. We present the case of a 53-year-old woman referred by her primary care physician for a screening colonoscopy. A single sessile polyp, measuring 4 mm in size, was found in the rectum. Histopathological examination revealed that the lesion was relatively well circumscribed and comprised mainly a mixture of polygonal cells with moderate-to-abundant pink slightly granular cytoplasm. The nuclei within these cells had frequent grooves and were occasionally folded. Immunohistochemical staining was positive for cd la which confirmed the diagnosis of LCH. On further workup, there was no evidence of involvement of any other organ. On follow up colonoscopy one year later, there was no evidence of disease recurrence. Review of the published literature revealed that LCH presenting as solitary colonic polyp is rare. However, with the increasing rates of screening colonoscopy, more colonic polyps may be identified as LCH on histopathology. This underscores the importance of recognizing this rare condition and ensuring proper follow-up to rule out systemic disease.

关键词： langerhans cells Histiocytosis Colonic pol-yp cd-la Eosinophilic granuloma Screening Colono-scopy

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