Crystal-storing histiocytosis: report of a case, review of the literature (80 cases) and a proposed classification

Head Neck Pathol. 2012 Mar;6(1):111-20. doi: 10.1007/s12105-011-0326-3. Epub 2012 Mar 20.

Abstract

We report a case of crystal storing histiocytosis (CSH) of the upper lip and cheek in a 51-year-old woman and review the clinicopathologic features of 80 cases in the literature. These occurred in 41 men and 39 women with a respective mean age of 59 and 61 years (range 17-81 years). Forty-six patients (58%) had localized CSH, and, of these, 16 (35%) occurred in the head and neck, with the most common site being the eye/orbit. The remaining 34 patients (42%) had generalized CSH primarily involving bone marrow, liver, lymph nodes, spleen and/or kidney. Regardless of whether the CSH was localized or generalized, the vast majority of patients (90%) had an underlying lymphoproliferative or plasma cell disorder, especially multiple myeloma, lymphoplasmacytic lymphoma, or monoclonal gammopathy of undetermined significance. In 7 cases (8.8%), the CSH was associated with a variety of benign disorders, often with an inflammatory background, and no evidence of a clonal lymphoproliferative or plasma cell disorder. Treatment and prognosis varied according to the underlying disease. A classification of CSH based on etiology and/or associated disease and chemical composition of the crystal is proposed, rare non-immunoglobulin variants of CSH are discussed, and a differential diagnosis of other potentially confusing lesions is provided.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Crystallization
  • Diagnosis, Differential
  • Female
  • Histiocytes / chemistry
  • Histiocytes / pathology*
  • Histiocytes / ultrastructure
  • Histiocytosis / classification*
  • Histiocytosis / pathology*
  • Humans
  • Immunoglobulins / analysis
  • Lip / pathology*
  • Microscopy, Electron
  • Middle Aged

Substances

  • Immunoglobulins