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LCH of Thyroid

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Langerhans Cell Histiocytosis (LCH) of Thyroid: Clusters of hyperplastic Langerhans cells may be seen in papillary thyroid carcinoma. In addition, papillary thyroid carcinomas are known to occur in multisystem LCH. Interestingly, both papillary thyroid carcinoma and LCH share BRAF V600E mutation.

Given the rarity of LCH involving thyroid, it is often not considered in the differential diagnosis by the cytopathologist (on FNA material) and frequently misdiagnosed as atypia of undetermined significance, undifferentiated carcinoma, or even diffuse large B-cell lymphoma.

This image shows sheets of Langerhans cells with grooved, folded or indented nuclei (arrows) admixed with numerous eosinophils.

Image courtesy of: Dr. Siba El Hussein; used with permission.

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