The histopathology of reactive florid dermatopathic lymphadenopathy shows overlap with Langerhans cell histiocytosis (LCH) involving the lymph node, which may lead to misdiagnosis. These entities can be distinguished by recognition of the sinus-based distribution of Langerhans cells in LCH, in contrast to the paracortical distribution of Langerhans cells, pigment-laden histiocytes, and small lymphocytes in dermatopathic lymphadenopathy.
