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Fig. 5D —16-year-old boy who presented with left-sided sixth-nerve palsy. Histologic specimen from mastoid biopsy shows Langerhans cells (arrows), which stain positively for S-100 and CD1a. Top image = H and E, x600. Bottom images are immunohistochemical stains with a brown chromogen. (Courtesy of Dr. Morris Edelman, New Hyde Park, NY)