CASE HISTORY
Histopathology
This 10-month-old baby boy from Venezuela had an expanding neck mass since the age of 5 months, thought to be an infection. The patient had been treated with antibiotics, with no response.
Histopathology
A biopsy was done and the material was sent via courier for review.
Histopathology
Histopathology
Histopathology
Medium power view shows a lymph node largely replaced by a proliferation of neoplastic cells.
Histopathology
Immunohistochemistry
Histopathology
At higher power, neoplastic cells with eosinophilic (pink) cytoplasm and irregular nuclei with frequent reniform shapes and central grooves are present, intermixed with occasional eosinophils.
Immunohistochemistry
Immunohistochemistry
Immunohistochemistry
Immunohistochemical staining showed strong cytoplasmic and nuclear expression of S100 protein by neoplastic cells (in brown).
Immunohistochemistry
Immunohistochemistry
Immunohistochemistry
In addition, neoplastic cells were strongly positive for CD1a (in brown).
2 weeks of treatment
2 weeks of treatment
Based on the pathology results, a diagnosis of Langerhans cell histiocytosis (LCH) was made. The case was immediately discussed with colleagues from Pediatric Hemato-oncology at Stanford and with Dr. Stock.
An LCH III treatment protocol was recommended, which was initiated the following day
2 weeks of treatment
2 weeks of treatment
2 weeks of treatment
At two weeks of initiating therapy, we see significant reduction of the patient's neck mass.
5 weeks of treatment
2 weeks of treatment
Six years later, the patient has become a handsome young boy with a big smile and free of disease
At 5 weeks, the patient's neck mass has almost completely disappeared.
Six years later, the patient has become a handsome young boy with a big smile and free of disease
Six years later, the patient has become a handsome young boy with a big smile and free of disease
Six years later, the patient has become a handsome young boy with a big smile and free of disease
