Eosinophilic granuloma of the parietal bone of an adult patient with BRAF mutation

• Published in: Arkhiv patologii Vol. 79; no. 4; p. 33
• Main Authors: Dolzhansky, O V, Paltseva, E M, Bukaeva, A A, Zaklyazminskaya, E V, Spivak, I A, Fedorov, D N
• Format: Journal Article
• Language: English; Russian
• Published: Russia (Federation) 2017
• Subjects: Adult; Eosinophilic Granuloma - diagnosis; Eosinophilic Granuloma - diagnostic imaging; Eosinophilic Granuloma - genetics; Eosinophilic Granuloma - pathology; Histiocytes; Histiocytosis, Langerhans-Cell - diagnosis; Histiocytosis, Langerhans-Cell - diagnostic imaging; Histiocytosis, Langerhans-Cell - genetics; Histiocytosis, Langerhans-Cell - pathology; Humans; Immunohistochemistry; Male; Mutation; Parietal Bone - diagnostic imaging; Parietal Bone - pathology; Proto-Oncogene Proteins B-raf - genetics; molecular genetics; eosinophilic granuloma; bone tissue; immunohistochemistry; Langerhans cell histiocytosis
• ISSN: 0004-1955
• DOI: 10.17116/patol201779433-39

The paper describes a case of eosinophilic granuloma of the parietal bone in a 32-year-old man. Histological examination revealed a large number of bean-shaped Langerhans cell histiocytes with lobed nuclei and nuclear grooves. The histiocytes alternated with the foci of obvious eosinophilic infiltration and with eosinophilic microabscesses. There were osteoclast-like multinucleated giant cells, bone resorption, and numerous bone rods covered with osteoblast chains. The histiocytes expressed CD1α, langerin, CD68, S100, and p53 (in 90.0% of the tumor cells). The Ki-67 proliferation index was 18.0%. A molecular genetic study identified BRAFV600E mutation (nucleotide substitution s.1799 T>A (p.V600E) in the heterozygous state). Clinical and morphological data and the results of molecular genetic studies led to the conclusion that there was eosinophilic granuloma of the right parietal bone (the unifocal form of Langerhans cell histiocytosis (LCH), type I, group A1, with the monoossal nature of lesion and with BRAFV600E mutation). In adults, this disease is extremely rare (2-5 cases of LCH per million people, bone loss in the fourth decade of life in 2.5% of the patients).