Primary cutaneous indeterminate cell histiocytosis following esophageal
cancer and followed by bullous pemphigoid: a case report from China
Abstract
Indeterminate cell histiocytosis (ICH) is a rare histiocytic
proliferative disease with unknown etigo, which shared immunophenotypic
features of Langerhans cell and macrophages. ICH cells express CD1a,
S-100, and CD68 whereas langerin (CD207) is negative. This study
presents a case of a 75 -year-old man with varying sizes of some
scattered annular erythema over his chest, abdomen, limbs and 4 bullous
on the thigh for 1.5months. He had about 9 month’s history of esophageal
cancer and treated with the radical radiotherapy treatment.
Histopathologic examination of his abdomen demonstrated accumulation of
mononuclear cells in the epidermis, infiltration of eosinophils and
lymphocytes in the dermal superficial layer. The histology of the
blister reported the formation of old subepidermal blister, slurry and
eosinophils in the blister as well as infiltration of eosinophils and
lymphocytes in the dermal superficial layer. Results of
immunohistochemistry identified positive for CD1a, S-100 and CD68 in
epidermal cells and dermal cells aggregation but negative for CD207.
However, the blisters and bullous were found over the lower limbs after
38 days. A diagnosis of bullous pemphigoid (BP) was arrived at according
to the examination of histopathology and direct immunofluorescent.
Therefore, that esophageal carcinoma, ICH, and BP lied in a single
patient, was found to be a rare case that deserved our considering of
the possible mechanism.