Oh, Histiocyte, oh histiocyte
Why are you, oh, so confusing?Seriously, what is up with the histiocytes?
(a la 'oh christmas tree' tune)
Not only can they be the regular old histiocytes that phagocytose debris (reactive), they can also be foamy (a la parasitized macrophages), be xanthomatous, be a proliferative disorder (benign OR malignant). There's more of what they can do that's just not coming to mind.
Who ARE these superpower cells? And why do we know so little about them?
Speaking of histiocytes, someone REALLY needs to look at the field and simplify the names. Jeff Callen? Vicky Werth? Anyone??
Look, why is Langerhans cell histicytosis also called Class I histiocytosis or histiocytosis X? Why does it comprise multiple named entities such as Letterer-Siwe disease, Hand-Schuller-Christian disease, eosinophilic granuloma, congenital self-healing reticulohistiocytosis (which is also called Hashimoto-Pritzker disease)? I understand that historically, they've been poorly understood, and that the numerous names reflect the lack of understanding and aggrement regarding their origins. But with the advent of electron microscopy and the development of immunohistochemical stains, we're now pretty sure that they're all related. Perhaps all variations along a theme? Along a spectrum?
I'm sure congestive heart failure probably had some misnomers and different names along the way, while it was being worked out. But once it got worked out, medicine as a field got together to simplify their nomenclature. Now you got just plain old CHF and diastolic CHF.
So now all we need is SOMEONE to stand up and say, enough with all these ridiculous names. Let's consolidate what we know today, lose the dead weight, and move the field ahead. Lump the problems and how to think about them into ways that make clinical sense.
Let's be lumpers, not splitters. I'm sure Letterer, Siwe, Hand, Schuller, Christian, Hashimoto, and Pritzker don't mind anymore...
photo credit electron microscopy of the classic Birbeck granules