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Editorial *Corresponding author Takuji Tanaka, Department of Diagnostic Pathology, Cytology is a powerful tool for Gifu Municipal Hospital, Japan, Email: Submitted: 20 December 2017 diagnosis of Langerhans cell Accepted: 21 December 2017 Published: 21 December 2017 hyperplasia/ ISSN: 2373-9282 Copyright Takuji Tanaka* © 2017 Tanaka Department of Diagnostic Pathology, Gifu Municipal Hospital, Japan OPEN ACCESS

EDITORIAL FNA (EUS-FNA) cytology or cell block with immunocytochemistry is helpful in making a rapid and correct diagnosis of LCH and LCS. Langerhans cells (LCs) derived from the CD34+ hematopoietic The authors suggested that highlighting diagnostic cytological precursor cells of the bone marrow are mobile, dendritic, features will help the pathologist in rendering a rapid and accurate antigen-presenting cells. The characteristic cytoplasmic cytological diagnosis, avoid unnecessary biopsy, and guide for marker, the Birbeck granules, is found ultrastructually in an early and appropriate management. The classical cytologic 10-week-old embryo. The expression of a more characteristic immunohistochemical and immunocytochemical marker, CD1a, is completed by 12 to 13 weeks of estimated gestational age. cells,findings including include eosinophils, high cellularity neutrophils, composed lymphocytes, of sheets/clusters plasma cells,and many multinucleated isolated LCs giant admixed cells and with macrophages. numerous The inflammatory key to the described Langerhans cells (LCs) in 1868, after making it visible Dr. Paul Langerhans, who also discovered pancreatic islets, first diagnosis is to identify the LC through its characteristic features, by means of a gold chloride technique. such as nuclear grooves and nuclear pseudo-inclusions.

Langerhans cell (LCH) and Langerhans cell sarcoma There are two types of tumors of LCs. They are classified into (LCS). LCH is the commonest disorder of the phagocytic system. HodgkinAccording lymphoma, to the melanoma,WHO classification, sarcoma LC and tumors undifferentiated have been The term LCH was introduced as an alternative to histiocytosis X carcinomasdifficult to differentiatedue to their fromsimilarities. other malignancies,Immunostaining such for as CD1a, non- by Dr. Nezel of in 1973. , Hand-Schuller- S-100, CD163, and CD207 (langerin) is useful for diagnosis of Christian Disease and Letterer-Siwe Syndrome are the three conditions that are believed to represent different expressions of cytological and histological features, mitotic activity would of the same disorder, now known as LCH. Due to the relative differentiateLC tumor. Although between diagnosis LCH (variable) is difficult and LCS due (>50 to the per similarity 10 high- rarity of the disease, estimating 0.5-5.4 cases per million persons as an annual incidence, its diagnosis is often delayed. Also, are known to be restricted to LC lesions of LC, the positive rate of many questions regarding etiology, pathogenesis and therapy BRAFpower mutations fields). BRAF in LCS mutations is lower in than histiocytic that in proliferative LCH. diseases are unanswered. LCH is characterized by clonal proliferation of pathogenic LCs. LCH occurs at any age, although the majority of Although neoplastic cells suggesting a histiocytic neoplasm the cases are diagnosed in children (newborn to 15 years). There are observed in cytology, it is hard to diagnose LCH or LCS only by from a solitary lesion to multifocal unisystem to multisystem or cell block materials may be useful for an accurate preoperative lesionsis no significant with related gender symptoms. difference. The clinical spectrum varies diagnosis.cytological Additionally,findings. Immunocytochemistry cytology can be very using useful FNA, for EUS-FNA staging and follow-up of the LC neoplasm. needle aspiration (FNA) cytology, endoscopic ultrasound-guided Recently several reports have been published in which fine

Cite this article: Tanaka T (2017) Cytology is a powerful tool for diagnosis of Langerhans cell hyperplasia/sarcoma. Ann Clin Pathol 5(5): 1126.