Cd1a-positive cells in bronchoalveolar lavage samples from children with Langerhans cell histiocytosis☆,☆☆,★
Section snippets
Patients
Forty-three BAL procedures were performed in 18 children between 2 months and 7 years of age with LCH and 61 BAL procedures in 60 children between 1 month and 15 years of age with miscellaneous lung disorders (control group). The children with LCH were divided into nonpulmonary unifocal (n = 6), nonpulmonary multifocal (n = 6), and pulmonary (as indicated by x-ray film, clinical examination, or both) multifocal (n = 6) groups. Further BAL samples were taken from five children with pulmonary
Control group
CD1a-positive cells were present in 8 (13%) of 60 children with a mean value of 0.10% ± 0.07%. In seven cases, fewer than 1% of the cells were CD1a-positive. In the eighth case (sarcoidosis), 4% were CD1a-positive.
Pulmonary multifocal group
More than 5% of cells showed CD1a positivity in the six patients. The mean percentage was 30.6% ± 7.2% (range, 10% to 55%), significantly higher than in the nonpulmonary multifocal, nonpulmonary unifocal, and control groups (Fig. 1). Radiologic abnormalities were present on the chest
DISCUSSION
To our knowledge, this is the first pediatric study of CD1a-positive cells in BAL fluid. The percentage of CD1a-positive cell counts in BAL fluid varies from 1.8% to 25% in adults with PLCH and from 0% to 3.6% in control groups, including a small number of patients with sarcoidosis.4, 5, 6 Children with PLCH had much higher CD1a-positive cell counts (10% to 55%). This difference may reflect the intense activity of LCH in children: the younger the child, the poorer the prognosis. In children,
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Diagnostic Utility of 3T Lung MRI in Children with Interstitial Lung Disease: A Prospective Pilot Study
2018, Academic RadiologyCitation Excerpt :Main investigations employed for the diagnosis of ILD include imaging, pulmonary function tests, bronchoalveolar lavage, and lung biopsy. Pulmonary function tests are difficult to perform in children because of poor cooperation (4), and bronchoalveolar lavage is of diagnostic value in a substantially limited number of conditions (5–8). Tissue biopsy provides a definitive diagnosis but has disadvantage of being invasive.
Pulmonary Langerhans cell histiocytosis in children: A spectrum of radiologic findings
2014, European Journal of RadiologyCitation Excerpt :Histopathologically, the disease is characterized by proliferation of Langerhans cell histiocytes (Fig. 1a). CD1a positivity and presence of cytoplasmic S-100 protein (Fig. 1b) are other useful indicators of this histiocytic disorder [16,17]. Electron microscopy may reveal characteristic Birbeck granules [12].
Disorders of Histiocytes
2012, Hematopathology: A Volume in the Series: Foundations in Diagnostic PathologyDisorders of Histiocytes
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From the Departments of Pneumologie et d'Allergologie Pédiatriques, Anatomopathologie, and Radiologie, Hôpital Necker-Enfants Malades, Paris, France
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Reprint requests: Luc Réfabert, MD, Service de Pneumologie et d'Allergologie Pédiatriques, Hôpital Necker-Enfants Malades, 149, rue de sevres, Paris, France.
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