Question
A 4-year-old boy presents with repeated infections, bone pains, short stature. O/E there was pallor, multiple old skin lesions/rashes, and wasting. Skull radiograph was s/o multiple lytic lesions. bone marrow biopsy showed special cells which showed. Immunohistochemistry and cytology studies showed cells being positive for S-100, CD1a, and CD207. What are the cells shown in the image referred to as:
| A. |
Tingible body macrophage
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| B. |
Downey cells
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| C. |
Blast cells
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| D. |
Birbeck’s granules
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Show Answer
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Correct Answer � D
Explanation
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Ans. D. Birbeck’s granules
These are tennis racket-shaped cells seen on an electron microscopy view, pathognomonic of Langerhans cell histiocytosis. Lytic lesions, skin lesions, and short stature ( pituitary stalk involvement ) likely indicate the diagnosis of the Hand-Schuller Christian variant of LCH.
Downey cells are atypical lymphocytes seen on peripheral smears indicative of infectious mononucleosis.
Blast cells are lymphocytes with large nucleus indicative of ALL/AML
Tingible body macrophages are stainable macrophages that scavenge apoptotic lymphocytes in a germinal center of reactive/neoplastic lymph node.
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