A middle-aged female present with lytic lesion in lower 1/3 of femur. Biopsy showed grooved nuclei and giant cells. No periosteal reaction seen. What is the confirmatory investigation for this case:-
Ans. (C) Cd1a and Langerin IHC(Ref: Apley's system of Orthopedics and Fracture 9th Ed; Page no-198 and 204)The possible diagnosis in the given scenario is Langerhans cell histiocytosis (LHC).Femur can be involved in LCH.LANGERHANS cells have a single large nucleus with characteristic folded or grooved nucleus (Coffee-Bean appearance) with small inconspicuous nucleoli.Visualization of the CD 1a surface marker is now considered sufficient to establish the diagnosis of LCH.
Serum PTH
Serum Calcitonin
Cd1a and Langerin IHC
MRI
Bone Tumour