Langerhans Cell Histiocytosis and Intracranial Germinoma: Are Immunohistology Techniques Helpful in Distinguishing Two Entities?
Journal Title: Journal of Neurological Sciences-Turkish - Year 2006, Vol 23, Issue 3
Abstract
Langerhans cell histiocytosis (LCH) is a clonal proliferative disease of the Langerhans cell. Langerhans cell bears abundant eosinophilic cytoplasm mainly associated with a matrix rich in eosinophils, mononuclear and multinucleated giant cells, neutrophils and mature lymphocytes. In the same way intracranial germinoma (ICG) consists of neoplastic germ cells having relatively moderate and/or abundant cytoplasm associated with an inflammatory background rich in lymphocytes. Histopathologic differentiation between ICG and LCH might be troublesome in some case. So far presence of eosinophils is accepted to be a crucial clue in differential diagnosis. In contrary, our experience emphasized eosinophils are present in both pathologic entities, i.e. LCH and ICG. We aim to document similarities and dissimilarities LCH and ICG, and frequency of eosinophils in ICG. Cases were obtained from the archives of pathology laboratory, Marmara University Hospital, Institute of Neurological Science. A series consisted of 10 ICG and 11 LCH specimens were obtained within a time period of 8 years, 1995 to 2003. We performed specific monoclonal antibodies against S-100, CD68, CD1a, PLAP, vimentin and Ki-67. Six cases were female and five cases were male of the LCH cases. If ICG nine cases were male and one case were female. S100, CD1a, CD68, vimentin were stained positively in the LCH. PLAP was stained positively in the ICG. MIB-1 index (detection anti-Ki-67 positive cells / overall population under investigation) value was remarkably higher in ICG. Although eosinophils were found to be almost in all LCH cases, in contrary in some of ICG’s. By conclusion, it clearly indicates that presence of the eosinophils should not be accepted as a specific criterion to be used distinguishing ICG from LCH.
Authors and Affiliations
Ahmet MİDİ, Süheyla BOZKURT, Özlem YAPICIER, Aydın SAV
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