The triptych of mixed histiocytosis: a systematic review of 105 cases and proposed clinical classification

Arturo Bonometti

Research output: Contribution to journalReview articlepeer-review


Histiocytoses are one of the ultimate diagnostic challenges that every physician face at least once in his/her life. Giving their protean manifestation and differentiated therapeutic needs, histiocytosis requires extensive characterization and multidisciplinary management. Mixed histiocytosis is an emerging group of syndromes defined by the overlap of Langerhans cell histiocytosis and another histiocytic disorder of different type. Despite rare, it may account for up to a fifth of systemic histiocytosis patients in some series. In this work, we comprehensively review for the first time the clinical, radiological, histopathological and molecular features of mixed histiocytosis in children and adults. Moreover, we propose a clinical classification in three groups that differentiate patients with systemic involvement and worse overall survival to other groups with more localized manifestations and indolent behavior, wanting to ease their recognition and treatment. Interestingly we also found that mixed histiocytosis harbor BRAFV600E mutations with a higher frequency comparing to all other histiocytoses, and may therefore benefit of specific inhibitory drugs.

Original languageEnglish
JournalLeukemia and Lymphoma
Publication statusAccepted/In press - 2020
Externally publishedYes


  • BRAF
  • classification
  • Erdheim–Chester disease
  • Histiocytosis
  • Langerhans cell histiocytosis
  • xanthogranuloma

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


Dive into the research topics of 'The triptych of mixed histiocytosis: a systematic review of 105 cases and proposed clinical classification'. Together they form a unique fingerprint.

Cite this