Langerhans' cell histiocytosis (LCH) is characterized by an accumulation of cells with a Langerhans' cell (LC) phenotype. Most patients present with solitary skin or bone lesions, but multi-organ lesions may appear. Twenty-two LCH-tissue sections from 13 children and adolescents, with lesions at different sites, were investigated for the expression of leukocyte cellular adhesion molecules. Surprisingly, the LCH cells showed expression for CD2 in 11 lesions. Staining of LCH cells for CD11a and CD11b was positive in six and three lesions, respectively. Staining for CD11c, CD44, CD54, and CD58 was found consistently positive in all lesions. The strong reactivity for CD54 (intercellular adhesion molecule-1) and CD58 (leukocyte function antigen-3) is in contrast with the epidermal LC. LCs in culture are known to up-regulate the expression of CD54 and CD58. These changes are thought to reflect the in vivo situation during migration of activated LCs from the skin to the draining lymph node. It can be concluded that the abnormal cells in LCH not only share characteristics with the epidermal LC, but have additional characteristics of the activated LC, a cell capable of migration. The presumed immunological dysregulation in LCH may affect the expression of cellular adhesion molecules, reflected by the inconsistent expression of CD11a and CD11b and the unexpected expression of CD2. These features may contribute to migration of LCs to aberrant sites in combination with abnormal persistence and proliferation.