Langerhans Cell Histiocytosis without Eosinophilia and Lytic Lesions of Bone: A Rare Disease with Unusual Presentation

LCH is a disease of abnormal clonal proliferation langerhans cell the bone marrow derived monocyte-macrophage lineage. Cells with characteristic coffee bean / grooved indented nuclei background histiocytes, lymphocytes, eosinophils and other inflammatory cells are seen. Clinical presentation varies from unifocal unisystem to multifocal multisystem. We present rare case multisystem involving high risk organs in two half year old child. presented chief complaints fever red raised maculopapular lesions on trunk, palm, forehead scalp for one yrs hepatosplenomegaly. There were no lytic bones. Hematological parameters showed anaemia thrombocytopenia while Bone Marrow Aspirate increase histiocytic some showing bean, cleaved irregularly contoured nuclei. However, eosinophilia was not Sections skin similar morphology without usually accompanied eosinophilia. The CD1a S100 positive. So FINAL DIAGNOSIS histiocytosis made. emphasis here lies thorough analysis clinical presentations, imaging studies scrupulous histomorphological immunohistochemical examination, so that early diagnosis timely intervention ensured such cases where features like found.