Masters Thesis

Reassessment of the prevalence of Langerhans Cell Histiocytosis among subadults in the St. Bride's Lower Churchyard collection

Focal studies of large skeletal collections have the potential to provide more comprehensive and intricate understandings of the populations that produced them. While large-scale initial analyses are vital to the overall interpretations of skeletal collections, the reported paleopathological diagnoses are often presumptive and the interpretations are broad. The St. Bride’s Lower Churchyard collection, associated with post-medieval London, has been the subject of a number of studies. However, few studies have focused on confirming the initial paleopathological diagnoses of the subadults within the collection. The initial analysis, performed by the Museum of London, found that roughly four percent of the subadults within this collection appeared to have suffered from Langerhans Cell Histiocytosis (LCH), an extremely rare clonal cell disorder. The skeletal indicators of this disease, multifocal lytic cranial lesions, are idiopathic and can be similar to changes associated with diseases endemic to post-medieval London, such as tuberculosis (TB) and rickets. Thirty subadults were selected for reanalysis: five with initially reported LCH, five with reported tuberculosis, one with rickets and scurvy, and nineteen subadults with no previously recorded pathognomonic pathologies. The results suggest that, while LCH cannot be ruled out when considering differential diagnoses for these individuals, the skeletal indicators upon which the initial paleopathological determination was based are also present on individuals diagnosed with different pathologies, or no pathologies at all. This study discusses the importance of focused paleopathological research and highlights the need for caution when making paleopathological diagnoses based on idiopathic skeletal indicators.

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