Abstract
Introduction: Indeterminate cell histiocytosis (ICH) is a rare histiocytic proliferative disease with unknown etigo, which shared immunophenotypic features of Langerhans cell and macrophages. There is a relationship between ICH and cancer, especially on the hematopoietic malignancy and follicular lymphoma.
Case report: This study presents a case of a 75 -year-old man with varying sizes of some scattered annular erythema over his chest, abdomen, limbs and 4 bullous on the thigh for 1.5months. He had about 9 month’s history of esophageal cancer and treated with the radical radiotherapy treatment. Histopathologic examination of his abdomen demonstrated accumulation of mononuclear cells in the epidermis, infiltration of eosinophils and lymphocytes in the dermal superficial layer. The histology of the blister reported the formation of old subepidermal blister, slurry and eosinophils in the blister as well as infiltration of eosinophils and lymphocytes in the dermal superficial layer. Results of immunohistochemistry identified positive for CD1a, S-100 and CD68 in epidermal cells and dermal cells aggregation but negative for CD207. However, the blisters and bullous were found over the lower limbs after 38 days. A diagnosis of bullous pemphigoid (BP) was arrived at according to the examination of histopathology and direct immunofluorescent. He did not agree to the treatment for BP as advised and died of multiple organ failure.
Conclusions: We hereby report the case of a patient with primary cutaneous ICH who had been diagnosed of esophageal cancer and treated with the radical radiotherapy several months ago, followed by BP. The association of ICH, esophageal cancer and BP has not been previously reported and the nature of the relationship among the disorders remains to be established.