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Central Nervous System Langerhans Cell Histiocytosis

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Histiocytic Disorders

Abstract

Langerhans cell histiocytosis (LCH) can affect virtually any organ of the human body, including the central nervous system (CNS). Based on correlation of clinical, imaging, and pathology findings, two patterns of CNS-LCH have been identified: granulomatous (“tumorous”) and non-granulomatous “neurodegenerative” (ND)-CNS-LCH. Granulomatous CNS-LCH can manifest with polyuria and polydipsia, seizures, increased intracranial pressure, or other signs, depending on location. The typical location on MRI is extra-axial (hypothalamic-pituitary region, meninges, pineal gland, choroid plexus), and pathology in a proliferative phase reveals CD1a/langerin+ histiocytes. ND-CNS-LCH manifests insidiously with cerebellar and bulbar symptoms. MRI typically reveals parenchymal signal alterations in the cerebellum, pons, basal ganglia, and supratentorial white matter consistent with neuronal loss and demyelination. Biopsies of such lesions are rare. In the few published cases biopsied, variable pathologies are described with perivascular inflammatory changes, variable neuronal loss, demyelination, and gliosis, but are nondiagnostic for CD1a+/CD207+ LCH cells. Granulomatous LCH can be responsive to chemotherapy agents such as vinblastine, cytarabine, or cladribine, while the optimal treatment of ND-CNS-LCH is yet to be defined.

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Abbreviations

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

DI:

Diabetes insipidus

ECD:

Erdheim-Chester disease

EDSS:

Expanded Disability Status Scale

FDG-PET:

Fluorodeoxyglucose positron emission tomography

HPR:

Hypothalamic-pituitary region

ICARS :

International Cooperative Ataxia Rating Scale

JXG :

Juvenile xanthogranuloma

LCH:

Langerhans cell histiocytosis

MAPK:

Mitogen-activated protein kinase

MRI:

Magnetic resonance imaging

MS-LCH:

Multisystem LCH

ND:

Neurodegeneration

PC:

Permanent consequences

RDD :

Rosai-Dorfman disease

SS-LCH:

Single system LCH

References

  1. Badalian-Very G, Vergilio JA, Fleming M, Rollins BJ. Pathogenesis of Langerhans cell histiocytosis. Annu Rev Pathol. 2013;8:1–20.

    Article  CAS  PubMed  Google Scholar 

  2. Chakraborty R, Hampton OA, Shen X, Simko SJ, Shih A, Abhyankar H, et al. Mutually exclusive recurrent somatic mutations in MAP2K1 and BRAF support a central role for ERK activation in LCH pathogenesis. Blood. 2014;124(19):3007–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Brown NA, Furtado LV, Betz BL, Kiel MJ, Weigelin HC, Lim MS, et al. High prevalence of somatic MAP2K1 mutations in BRAF V600E-negative Langerhans cell histiocytosis. Blood. 2014;124(10):1655–8.

    Article  CAS  PubMed  Google Scholar 

  4. Berres ML, Lim KP, Peters T, Price J, Takizawa H, Salmon H, et al. BRAF-V600E expression in precursor versus differentiated dendritic cells defines clinically distinct LCH risk groups. J Exp Med. 2014;211(4):669–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. McLelland J, Broadbent V, Yeomans E, Malone M, Pritchard J. Langerhans cell histiocytosis: the case for conservative treatment. Arch Dis Child. 1990;65(3):301–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Minkov M, Grois N, Heitger A, Potschger U, Westermeier T, Gadner H, et al. Response to initial treatment of multisystem Langerhans cell histiocytosis: an important prognostic indicator. Med Pediatr Oncol. 2002;39(6):581–5.

    Article  PubMed  Google Scholar 

  7. Minkov M. Multisystem Langerhans cell histiocytosis in children: current treatment and future directions. Paediatr Drugs. 2011;13(2):75–86.

    Article  PubMed  Google Scholar 

  8. Grois N, Potschger U, Prosch H, Minkov M, Arico M, Braier J, et al. Risk factors for diabetes insipidus in langerhans cell histiocytosis. Pediatr Blood Cancer. 2006;46(2):228–33.

    Article  CAS  PubMed  Google Scholar 

  9. Minkov M, Steiner M, Potschger U, Arico M, Braier J, Donadieu J, et al. Reactivations in multisystem Langerhans cell histiocytosis: data of the international LCH registry. J Pediatr. 2008;153(5):700–5, 5 e1–2.

    Article  PubMed  Google Scholar 

  10. Morimoto A, Kobayashi R, Maeda M, Asami K, Bessho F, Imashuku S, et al. Impact of reactivation on the sequelae of multi-system Langerhans cell histiocytosis patients. Pediatr Blood Cancer. 2008;50(4):931–2. author reply 2

    Article  PubMed  Google Scholar 

  11. Pollono D, Rey G, Latella A, Rosso D, Chantada G, Braier J. Reactivation and risk of sequelae in Langerhans cell histiocytosis. Pediatr Blood Cancer. 2007;48(7):696–9.

    Article  PubMed  Google Scholar 

  12. Haupt R, Nanduri V, Calevo MG, Bernstrand C, Braier JL, Broadbent V, et al. Permanent consequences in Langerhans cell histiocytosis patients: a pilot study from the Histiocyte Society-late effects study group. Pediatr Blood Cancer. 2004;42(5):438–44.

    Article  PubMed  Google Scholar 

  13. A multicentre retrospective survey of Langerhans’ cell histiocytosis: 348 cases observed between 1983 and 1993. The French Langerhans’ cell Histiocytosis study group. Arch Dis Child. 1996;75(1):17–24.

    Google Scholar 

  14. Grois N, Barkovich AJ, Rosenau W, Ablin AR. Central nervous system disease associated with Langerhans’ cell histiocytosis. Am J Pediatr Hematol Oncol. 1993;15(2):245–54.

    Article  CAS  PubMed  Google Scholar 

  15. Laurencikas E, Gavhed D, Stalemark H, van’t Hooft I, Prayer D, Grois N, et al. Incidence and pattern of radiological central nervous system Langerhans cell histiocytosis in children: a population based study. Pediatr Blood Cancer. 2011;56(2):250–7.

    Google Scholar 

  16. Wnorowski M, Prosch H, Prayer D, Janssen G, Gadner H, Grois N. Pattern and course of neurodegeneration in Langerhans cell histiocytosis. J Pediatr. 2008;153(1):127–32.

    Article  PubMed  Google Scholar 

  17. Imashuku S, Shioda Y, Kobayashi R, Hosoi G, Fujino H, Seto S, et al. Neurodegenerative central nervous system disease as late sequelae of Langerhans cell histiocytosis. Report from the Japan LCH study group. Haematologica. 2008;93(4):615–8.

    Article  PubMed  Google Scholar 

  18. Gadner H, Heitger A, Ritter J, Gobel U, Janka GE, Kuhl J, et al. Langerhans cell histiocytosis in childhood--results of the DAL-HX 83 study. Klin Padiatr. 1987;199(3):173–82.

    Article  CAS  PubMed  Google Scholar 

  19. Willis B, Ablin A, Weinberg V, Zoger S, Wara WM, Matthay KK. Disease course and late sequelae of Langerhans’ cell histiocytosis: 25-year experience at the University of California, san Francisco. J Clin Oncol Off J Am Soc Clin Oncol. 1996;14(7):2073–82.

    Article  CAS  Google Scholar 

  20. Gavhed D, Akefeldt SO, Osterlundh G, Laurencikas E, Hjorth L, Blennow K, et al. Biomarkers in the cerebrospinal fluid and neurodegeneration in Langerhans cell histiocytosis. Pediatr Blood Cancer. 2009;53(7):1264–70.

    Article  PubMed  Google Scholar 

  21. Grois N, Prayer D, Prosch H, Lassmann H, Group CLC-o. Neuropathology of CNS disease in Langerhans cell histiocytosis. Brain J Neurol. 2005;128(Pt 4):829–38.

    Article  Google Scholar 

  22. Imashuku S, Arceci RJ. Strategies for the prevention of central nervous system complications in patients with langerhans cell histiocytosis: the problem of neurodegenerative syndrome. Hematol Oncol Clin North Am. 2015;29(5):875–93.

    Article  PubMed  Google Scholar 

  23. Picarsic J, Murdoch G, Chakraborty R, Castro-Silva F, Panigrahy A, Jaffe R, et al. Revisiting the neuropathology of central nervous system Langerhans cell histiocytosis. Abstracts from the 32nd Annual Meeting of the Histiocyte Society Dublin, Ireland October 17-19, 2016. Pediatr Blood Cancer. 2016;63(Suppl 2):S29–30.

    Google Scholar 

  24. Zinn D, Picarsic J, Chakraborty R, Lin H, Abhyankar H, Scull B. Elevated CSF osteopontin and peripheral blood cells with braf mutations in patients with langerhans cell histiocytosis-associated neurodegeneration. Abstracts from the 32nd Annual Meeting of the Histiocyte Society Dublin, Ireland October 17-19, 2016. Pediatr Blood Cancer. 2016;63(Suppl 2):S37–8.

    Google Scholar 

  25. Imashuku S, Ishida S, Koike K, Ichikawa M, Minato T, Suzuki Y, et al. Cerebellar ataxia in pediatric patients with Langerhans cell histiocytosis. J Pediatr Hematol Oncol. 2004;26(11):735–9.

    Article  PubMed  Google Scholar 

  26. D’Ambrosio N, Soohoo S, Warshall C, Johnson A, Karimi S. Craniofacial and intracranial manifestations of langerhans cell histiocytosis: report of findings in 100 patients. AJR Am J Roentgenol. 2008;191(2):589–97.

    Article  PubMed  Google Scholar 

  27. Prayer D, Grois N, Prosch H, Gadner H, Barkovich AJ. MR imaging presentation of intracranial disease associated with Langerhans cell histiocytosis. AJNR Am J Neuroradiol. 2004;25(5):880–91.

    PubMed  Google Scholar 

  28. Grois N, Fahrner B, Arceci RJ, Henter JI, McClain K, Lassmann H, et al. Central nervous system disease in Langerhans cell histiocytosis. J Pediatr. 2010;156(6):873–81, 81 e1.

    Article  PubMed  Google Scholar 

  29. Chellapandian D, Shaikh F, van den Bos C, Somers GR, Astigarraga I, Jubran R, et al. Management and outcome of patients with Langerhans cell histiocytosis and single-bone CNS-risk lesions: a multi-institutional retrospective study. Pediatr Blood Cancer. 2015;62(12):2162–6.

    Article  PubMed  Google Scholar 

  30. Harris GJ. Langerhans cell histiocytosis of the orbit: a need for interdisciplinary dialogue. Am J Ophthalmol. 2006;141(2):374–8.

    Article  PubMed  Google Scholar 

  31. Harris GJ, Woo KI. Is unifocal Langerhans-cell histiocytosis of the orbit a “CNS-risk” lesion? Pediatr Blood Cancer. 2004;43(3):298–9. author reply 300-1

    Article  PubMed  Google Scholar 

  32. Christian HA. Defects in membranous bones, exophthalmos and diabetes insipidus; an unusual syndrome of dyspituitarism: a clinical study. Horm Res. 1920;53:61–4.

    Google Scholar 

  33. Hand A. Defects of membranous bones, exophthalmos and polyuria in childhood: is it dyspituitarism? Am J Med Sci. 1921;162:509–15.

    Article  Google Scholar 

  34. Schüller A. Über eigenartige Schädeldefekte im Jugendalter. Fortschr Geb Röntgenstr. 1915;23:12–9.

    Google Scholar 

  35. Barthez MA, Araujo E, Donadieu J. Langerhans cell histiocytosis and the central nervous system in childhood: evolution and prognostic factors. Results of a collaborative study. J Child Neurol. 2000;15(3):150–6.

    Article  CAS  PubMed  Google Scholar 

  36. Greenwood SM, Martin JS, Towfighi J. Unifocal eosinophilic granuloma of the temporal lobe. Surg Neurol. 1982;17(6):441–4.

    Article  CAS  PubMed  Google Scholar 

  37. Report of the Histiocyte Society workshop on “central nervous system (CNS) disease in Langerhans cell histiocytosis (LCH)”. Medical and pediatric oncology. 1997;29(2):73–78.

    Google Scholar 

  38. Donadieu J, Rolon MA, Thomas C, Brugieres L, Plantaz D, Emile JF, et al. Endocrine involvement in pediatric-onset Langerhans’ cell histiocytosis: a population-based study. J Pediatr. 2004;144(3):344–50.

    Article  PubMed  Google Scholar 

  39. Grois N, Prayer D, Prosch H, Minkov M, Potschger U, Gadner H. Course and clinical impact of magnetic resonance imaging findings in diabetes insipidus associated with Langerhans cell histiocytosis. Pediatr Blood Cancer. 2004;43(1):59–65.

    Article  PubMed  Google Scholar 

  40. Prosch H, Feldges A, Grois N, Fretz C, Spieler P, Minkov M, et al. Demonstration of CD1a positive cells in the cerebrospinal fluid--a clue to diagnosis of isolated Langerhans cell histiocytosis of the hypothalamic-pituitary axis? Med Pediatr Oncol. 2003;41(5):474–6.

    Article  PubMed  Google Scholar 

  41. Grois NG, Favara BE, Mostbeck GH, Prayer D. Central nervous system disease in Langerhans cell histiocytosis. Hematol Oncol Clin North Am. 1998;12(2):287–305.

    Article  CAS  PubMed  Google Scholar 

  42. Prosch H, Grois N, Wnorowski M, Steiner M, Prayer D. Long-term MR imaging course of neurodegenerative Langerhans cell histiocytosis. AJNR Am J Neuroradiol. 2007;28(6):1022–8.

    Article  CAS  PubMed  Google Scholar 

  43. Buchler T, Cervinek L, Belohlavek O, Kantorova I, Mechl M, Nebesky T, et al. Langerhans cell histiocytosis with central nervous system involvement: follow-up by FDG-PET during treatment with cladribine. Pediatr Blood Cancer. 2005;44(3):286–8.

    Article  PubMed  Google Scholar 

  44. Calming U, Bemstrand C, Mosskin M, Elander SS, Ingvar M, Henter JI. Brain 18-FDG PET scan in central nervous system langerhans cell histiocytosis. J Pediatr. 2002;141(3):435–40.

    Article  PubMed  Google Scholar 

  45. Ribeiro MJ, Idbaih A, Thomas C, Remy P, Martin-Duverneuil N, Samson Y, et al. 18F-FDG PET in neurodegenerative Langerhans cell histiocytosis : results and potential interest for an early diagnosis of the disease. J Neurol. 2008;255(4):575–80.

    Article  PubMed  Google Scholar 

  46. Steiner M, Prayer D, Asenbaum S, Prosch H, Minkov M, Unger E, et al. Modern imaging methods for the assessment of Langerhans’ cell histiocytosis-associated neurodegenerative syndrome: case report. J Child Neurol. 2005;20(3):253–7.

    Article  PubMed  Google Scholar 

  47. Gadner H, Heitger A, Grois N, Gatterer-Menz I, Ladisch S. Treatment strategy for disseminated Langerhans cell histiocytosis. DAL HX-83 study group. Med Pediatr Oncol. 1994;23(2):72–80.

    Article  CAS  PubMed  Google Scholar 

  48. Gadner H, Minkov M, Grois N, Potschger U, Thiem E, Arico M, et al. Therapy prolongation improves outcome in multisystem Langerhans cell histiocytosis. Blood. 2013;121(25):5006–14.

    Article  CAS  PubMed  Google Scholar 

  49. Grois N, Flucher-Wolfram B, Heitger A, Mostbeck GH, Hofmann J, Gadner H. Diabetes insipidus in Langerhans cell histiocytosis: results from the DAL-HX 83 study. Med Pediatr Oncol. 1995;24(4):248–56.

    Article  CAS  PubMed  Google Scholar 

  50. Nanduri VR, Bareille P, Pritchard J, Stanhope R. Growth and endocrine disorders in multisystem Langerhans’ cell histiocytosis. Clin Endocrinol. 2000;53(4):509–15.

    Article  CAS  Google Scholar 

  51. Nanduri VR, Pritchard J, Levitt G, Glaser AW. Long term morbidity and health related quality of life after multi-system Langerhans cell histiocytosis. Eur J Cancer. 2006;42(15):2563–9.

    Article  PubMed  Google Scholar 

  52. Prosch H, Grois N, Bokkerink J, Prayer D, Leuschner I, Minkov M, et al. Central diabetes insipidus: is it Langerhans cell histiocytosis of the pituitary stalk? A diagnostic pitfall. Pediatr Blood Cancer. 2006;46(3):363–6.

    Article  PubMed  Google Scholar 

  53. Prosch H, Grois N, Prayer D, Waldhauser F, Steiner M, Minkov M, et al. Central diabetes insipidus as presenting symptom of Langerhans cell histiocytosis. Pediatr Blood Cancer. 2004;43(5):594–9.

    Article  PubMed  Google Scholar 

  54. Allen CE, Ladisch S, McClain KL. How I treat Langerhans cell histiocytosis. Blood. 2015;126(1):26–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Gabbay LB, Leite Cda C, Andriola RS, Pinho Pda C, Lucato LT. Histiocytosis: a review focusing on neuroimaging findings. Arq Neuropsiquiatr. 2014;72(7):548–58.

    Article  PubMed  Google Scholar 

  56. Abla O, Weitzman S, Minkov M, McClain KL, Visser J, Filipovich A, et al. Diabetes insipidus in Langerhans cell histiocytosis: when is treatment indicated? Pediatr Blood Cancer. 2009;52(5):555–6.

    Article  PubMed  Google Scholar 

  57. Abla O, Palmert MR. Reversal of LCH-related diabetes insipidus and reappearance of posterior pituitary bright spot with low-dose chemotherapy. Pediatr Blood Cancer. 2012;59(1):201–2.

    Article  PubMed  Google Scholar 

  58. Allen CE, Flores R, Rauch R, Dauser R, Murray JC, Puccetti D, et al. Neurodegenerative central nervous system Langerhans cell histiocytosis and coincident hydrocephalus treated with vincristine/cytosine arabinoside. Pediatr Blood Cancer. 2010;54(3):416–23.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Dhall G, Finlay JL, Dunkel IJ, Ettinger LJ, Kellie SJ, Allen JC, et al. Analysis of outcome for patients with mass lesions of the central nervous system due to Langerhans cell histiocytosis treated with 2-chlorodeoxyadenosine. Pediatr Blood Cancer. 2008;50(1):72–9.

    Article  PubMed  Google Scholar 

  60. Ng Wing Tin S, Martin-Duverneuil N, Idbaih A, Garel C, Ribeiro M, Parker JL, et al. Efficacy of vinblastine in central nervous system Langerhans cell histiocytosis: a nationwide retrospective study. Orphanet J Rare Dis. 2011;6(1):83.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Simko SJ, Tran HD, Jones J, Bilgi M, Beaupin LK, Coulter D, et al. Clofarabine salvage therapy in refractory multifocal histiocytic disorders, including Langerhans cell histiocytosis, juvenile xanthogranuloma and Rosai-Dorfman disease. Pediatr Blood Cancer. 2014;61(3):479–87.

    Article  CAS  PubMed  Google Scholar 

  62. Simko SJ, McClain KL, Allen CE. Up-front therapy for LCH: is it time to test an alternative to vinblastine/prednisone? Br J Haematol. 2015;169(2):299–301.

    Article  CAS  PubMed  Google Scholar 

  63. Grois N, Tsunematsu Y, Barkovich AJ, Favara BE. Central nervous system disease in Langerhans cell histiocytosis. Br J Cancer Suppl. 1994;23:S24–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  64. Mimouni-Bloch A, Schneider C, Politi KE, Konen O, Gothelf D, Stark B, et al. Neuropsychiatric manifestations in Langerhans’ cell histiocytosis disease: a case report and review of the literature. J Child Neurol. 2010;25(7):884–7.

    Article  PubMed  Google Scholar 

  65. Mittheisz E, Seidl R, Prayer D, Waldenmair M, Neophytou B, Potschger U, et al. Central nervous system-related permanent consequences in patients with Langerhans cell histiocytosis. Pediatr Blood Cancer. 2007;48(1):50–6.

    Article  PubMed  Google Scholar 

  66. Van’t Hooft I, Gavhed D, Laurencikas E, Henter JI. Neuropsychological sequelae in patients with neurodegenerative Langerhans cell histiocytosis. Pediatr Blood Cancer. 2008;51(5):669–74.

    Article  PubMed  Google Scholar 

  67. Vrijmoet-Wiersma CM, Kooloos VM, Koopman HM, Kolk AM, van der Laan I, Grootenhuis MA, et al. Health-related quality of life, cognitive functioning and behaviour problems in children with Langerhans cell histiocytosis. Pediatr Blood Cancer. 2009;52(1):116–22.

    Article  PubMed  Google Scholar 

  68. Whitsett SF, Kneppers K, Coppes MJ, Egeler RM. Neuropsychologic deficits in children with Langerhans cell histiocytosis. Med Pediatr Oncol. 1999;33(5):486–92.

    Article  CAS  PubMed  Google Scholar 

  69. Kepes JJ, Histiocytosis X. In: Vinken PJ, Brujn GW, editors. Handbook of neurology, vol. 83. New York: Elsevier; 1979. p. 93–117.

    Google Scholar 

  70. Imashuku S, Fujita N, Shioda Y, Noma H, Seto S, Minato T, et al. Follow-up of pediatric patients treated by IVIG for Langerhans cell histiocytosis (LCH)-related neurodegenerative CNS disease. Int J Hematol. 2015;101(2):191–7.

    Article  PubMed  Google Scholar 

  71. Imashuku S, Okazaki N, Nakayama M, Fujita N, Fukuyama T, Koike K, et al. Treatment of neurodegenerative CNS disease in Langerhans cell histiocytosis with a combination of intravenous immunoglobulin and chemotherapy. Pediatr Blood Cancer. 2008;50(2):308–11.

    Article  PubMed  Google Scholar 

  72. Gavhed D, Laurencikas E, Akefeldt SO, Henter JI. Fifteen years of treatment with intravenous immunoglobulin in central nervous system Langerhans cell histiocytosis. Acta Paediatr. 2011;100(7):e36–9.

    Article  PubMed  Google Scholar 

  73. Idbaih A, Donadieu J, Barthez MA, Geissmann F, Bertrand Y, Hermine O, et al. Retinoic acid therapy in “degenerative-like” neuro-langerhans cell histiocytosis: a prospective pilot study. Pediatr Blood Cancer. 2004;43(1):55–8.

    Article  PubMed  Google Scholar 

  74. Geissmann F, Landman-Parker J, Thomas C, Donadieu J, Brousse N, Hermine O. In vitro effects of retinoic acid on Langerhans cell histiocytosis cells and normal dendritic cells. Abstracts of the Annual Meeting 1997 of the Histiocyte Society. Pediatr Blood Cancer. 1998;31(1):49.

    Google Scholar 

  75. Euskirchen P, Haroche J, Emile JF, Buchert R, Vandersee S, Meisel A. Complete remission of critical neurohistiocytosis by vemurafenib. Neurol Neuroimmunol Neuroinflamm. 2015;2(2):e78.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Donadieu J, Visser J, Sieni E, Kabbara N, Jehanne M, Pagnier A, et al. Vemurafenib in children with refractory LCH: 21 patients treated in France, UK, Italy and Lebanon. Abstracts from the 32nd Annual Meeting of the Histiocyte Society Dublin, Ireland October 17-19, 2016. Pediatr Blood Cancer. 2016;63(Suppl 2):16.

    Google Scholar 

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Authors and Affiliations

  1. International LCH Study Reference Center, CCRI, St. Anna Kinderkrebsforschung, Department of Pediatrics and Adolescent Medicine,Medical University of Vienna, Vienna, A-1090, Austria

    Milen Minkov MD, PhD

  2. St. Anna Children’s Hospital, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, A-1090, Austria

    Milen Minkov MD, PhD & Karoly Lakatos MD

  3. Department of Pathology, University of Pittsburgh School of Medicine, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA

    Jennifer Picarsic MD

Authors
  1. Milen Minkov MD, PhD
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  2. Jennifer Picarsic MD
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  3. Karoly Lakatos MD
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Correspondence to Milen Minkov MD, PhD .

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Editors and Affiliations

  1. University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada

    Oussama Abla

  2. Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany

    Gritta Janka

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Minkov, M., Picarsic, J., Lakatos, K. (2018). Central Nervous System Langerhans Cell Histiocytosis. In: Abla, O., Janka, G. (eds) Histiocytic Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-59632-7_4

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