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 CASE REPORT
Year : 2011  |  Volume : 77  |  Issue : 3  |  Page : 318--320

Paraneoplastic multicentric reticulohistiocytosis: A clinicopathologic challenge


1 Department of Pathology, St. John's Medical College and Hospital, Bangalore - 560 034, India
2 Department of Dermatology, St. John's Medical College and Hospital, Bangalore - 560 034, India
3 Department of Medical Oncology, St. John's Medical College and Hospital, Bangalore - 560 034, India
4 Department of Clinical Pathology, St. John's Medical College and Hospital, Bangalore - 560 034, India

Correspondence Address:
Rajalakshmi Tirumalae
Department of Pathology, St. John's Medical College, Bangalore-560 034
India
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DOI: 10.4103/0378-6323.79704

PMID: 21508571

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Multicentric Reticulohistiocytosis (MRH) is a rare, systemic non-Langerhans cell histiocytosis (non-LCH) with prominent joint and skin manifestations. It is mostly self limiting. However, 15-30% of the cases are associated with malignancy and carry a poor prognosis. We report the case of a 42-year-old man who presented with multiple reddish-brown papules that on biopsy showed aggregates of oncocytic histiocytes with several multinucleate giant cells. Immunostains were positive for CD 68, CD 45 and were negative for S-100, CD1a. An impression of multicentric reticulohistiocytosis (MRH) was made, with the recommendation to screen for malignancy. Electron microscopy of the skin lesions showed features consistent with non-Langerhans cell histiocytosis. The patient was later diagnosed with acute myeloid leukemia at a follow-up visit several months later. Thus, it appears prudent to screen and follow-up adults with MRH, to identify an underlying malignant condition.






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