Histiocytosis x: light and electron microscopic study with special reference to skin manifestations

ABSTRACT

A total of 25 cases of histiocytic infiltration of the skin were studied. These comprised 15 patients diagnosed as having histiocytosis X [12 cases of eosinophilic granuloma, one case of Hand- Schueller-Christian disease and two cases of letterer Siwe disease] and 10 cases of non-X histiocytic lesions of the skin and subcutaneous tissues [two cases of xanthogranuloma and eight fibrous histiocytomas]. The various cutaneous lesions encountered were described. The diagnostic histopathologic features of each group were presented. Langerhans cells with folded, indented or lobulated nuclei were identified in all the 15 cases of histiocytosis X. Langerhans granules, trilaminar membranous loops and comma shaped bodies were found in 20-50% of cells of all the five cases of histiocytosis X examined ultrastructurally irrespective to the clinical form of the disease. The importance of electron microscopy as a diagnostic tool for confirmation of the diagnosis and differentiating those cutaneous lesions due to histiocytosis X from non-X histiocytic tumors is emphasized