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Introduction. Langerhans cell histiocytosis (LCH), as a hematopoietic neoplasm, is a clonal proliferation of Langerhans dendritic cells. A comprehensive clinical examination is sometimes crucial for detecting rare adult diseases, such as LCH with concomitant autoimmune thyroid disease. Case report. A 43-year-old female patient first presented for an endocrinology consultation due to front neck pain and swelling accompanied by fatigue and malaise. The physical examination revealed an enlarged right thyroid gland lobe of extremely firm consistency that was painfully tender on palpation. Echosonographic findings confirmed that the right thyroid gland lobe was enlarged and was not clearly demarcated from the surrounding tissue while exhibiting pronounced parenchyma inhomogeneity characterized by reduced echogenicity of the anterior aspect and pronounced hypoechoicity of the posterior aspect, permeated with fibrous bands and calcifications. The structure of the left thyroid lobe was pseudonodular, with the characteristics of a chronic inflammatory process. Biohumoral findings indicated chronic auto-immune thyroiditis and primary hypothyroidism. Medical history, clinical findings, and personal and family predisposition to malignancy confirmed the need for accelerated additional diagnosis. Fine-needle aspiration biopsy was indicative of atypia of undetermined significance involving Hurthle cells, nuclear overlaps, anisocytosis, anisonucleosis, and the presence of nuclear incisions. Analyses performed after thyroidectomy pointed to the fibrous form of chronic thyroiditis, with suspected monoclonal proliferation of histiocytic and/or lymphoid cells. Immunohistochemical findings confirmed Hashimoto’s thyroiditis and LCH. As the post-operative course was favorable, the patient was prescribed L-thyroxine replacement therapy, along with continuous and systematic monitoring for histiocytosis. Conclusion. Histiocytosis should be suspected more often, given the high incidence of autoimmune thyroid disease in adulthood. A timely LCH diagnosis largely determines the outcome.

The localization of calbindin in the kidney and cerebellum of Hystrix cristata was investigated immu­nohistochemically using an antiserum against the 28k Da calbindin of chicken duodenum. Calbindin-D28k is an intracellular protein with a high affinity for calcium. This protein is exclusively localized in the distal convoluted tubules of the kidney and in Purkinje cells of the cerebellum. Functionaly, calbindin-D28k is supposed to be involved in the regulation of the reabsorption of calcium in the distal nephron, though the exact regulatory mechanisms are not yet known.

As the most potent antigen presenting cells, dendritic cells (DCs) play key roles in the immune response against tumors. Their density in the tumor tissue has been associated with prognosis in patients with various cancers. However, few studies have been aimed at the presence and maturation state of DCs in cutaneous melanoma, with regard to their potential clinical correlates. In this study, the density of DCs expressing CD1a and the maturation marker DC-LAMP was determined by immunohistochemistry in primary tumor samples from 82 patients with cutaneous malignant melanoma. Intratumoral and peritumoral cell densities were analyzed in relation to tumor thickness and the subsequent development of metastases, as well as to patients’ survival. CD1a+ DCs were found both infiltrating melanoma cell nests and in the surrounding stroma, while DC-LAMP+ mature DCs were generally confined to the peritumoral areas, associated with lymphocytic infiltrates. DC density values significantly correlated with the number of activated (CD25+ or OX40+) T lymphocytes ( p < 0.001). The degree of infiltration by CD1a+ and DC-LAMP+ DCs showed strong inverse correlation with the thickness of melanomas ( p < 0.001). High peritumoral density of mature DCs was associated with significantly longer survival ( p = 0.0195), while density of CD1a+ cells had a prognostic impact of borderline significance ( p = 0.0610). Moreover, combination of high peritumoral CD1a+ or DC-LAMP+ cell density with high number of CD25+ or OX40+ lymphocytes identified patient subgroups with more favorable survival compared to other subgroups. A multivariate survival analysis involving DC and activated T-cell densities alone and in combinations, as well as traditional prognostic factors, identified high DC-LAMP+ cell/high OX40+ cell density and Breslow index as independent predictors of good prognosis. These results suggest that the presence of CD1a+ DCs primarily depends on the thickness of melanomas, without direct relationship with the patients’ survival. On the other hand, the density of mature DCs, especially in association with that of activated T cells, proved of prognostic importance, suggesting that these parameters could be considered as signs of a functional immune response associated with better outcome of the disease. [ABSTRACT FROM AUTHOR]