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Zhang J, Zong S, Liao B. Langerhans cell histiocytosis developing acute lymphoblastic leukemia. SAGE Open Med Case Rep 2022; 10:2050313X221080328. [PMID: 35237442 PMCID: PMC8883370 DOI: 10.1177/2050313x221080328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/10/2022] [Indexed: 11/16/2022] Open
Abstract
The sequential occurrence of Langerhans cell histiocytosis and acute leukemia in only one individual has been reported previously; however, it is rarely observed that Langerhans cell histiocytosis can transform into acute lymphoblastic leukemia, and the underlying mechanisms remain unclear. In this report, we have analyzed a case of acute lymphoblastic leukemia converted from Langerhans cell histiocytosis using high-throughput sequencing method, and found that mitogen-activated protein kinase gene mutation, which can act as a marker for poor prognosis, might be involved in disease transformation. This is the first description about acute lymphoblastic leukemia B-cell type after Langerhans cell histiocytosis diagnosis and therapy in China.
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Affiliation(s)
- JinFang Zhang
- Department of Paediatric Hematology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Sa Zong
- Department of Paediatric Hematology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Bing Liao
- Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Kime A, Bréal C, Cottereau AS, Friedrich C, Decroocq J, Kaltenbach S, Lupo A, Copin MC, Pasmant E, Deschamps P, Emile JF, Bouscary D, Burroni B. Malignant histiocytosis with a Langerhans cell subtype: A report on the diagnostic and therapeutic challenge. Blood Cells Mol Dis 2021; 92:102623. [PMID: 34751149 DOI: 10.1016/j.bcmd.2021.102623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Amel Kime
- Service de pathologie, AP-HP, Hôpital Cochin, F-75014 Paris, France.
| | - Claire Bréal
- Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Service d'Hématologie clinique, Hôpital Cochin, Paris, France
| | - Anne-Ségolène Cottereau
- Service de médecine nucléaire, AP-HP, Hôpital Cochin, F-75014 Paris, France, Université de Paris, 75006 Paris, France
| | - Chloe Friedrich
- Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016, Paris, France
| | - Justine Decroocq
- Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Service d'Hématologie clinique, Hôpital Cochin, Paris, France; Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016, Paris, France
| | - Sophie Kaltenbach
- Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Laboratoire d'Onco-Hématologie, Hôpital Necker-Enfants maladies, Paris, France; Université de Paris, Institut Necker-Enfants Malades, INSERM U1151, Paris, France
| | - Audrey Lupo
- Service de pathologie, AP-HP, Hôpital Cochin, F-75014 Paris, France; Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, F-75006 Paris, France
| | - Marie-Christine Copin
- Univ Angers, Université de Nantes, CHU Angers, Inserm, CRCINA, SFR ICAT, Département de pathologie, F-49000 Angers, France
| | - Eric Pasmant
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, DMU BioPhyGen, AP-HP, Centre-Université de Paris, Paris, France; Institut Cochin, Inserm U1016 CNRS UMR8104 Université de Paris, CARPEM, Paris, France
| | - Paul Deschamps
- Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Service d'Hématologie clinique, Hôpital Cochin, Paris, France
| | - Jean-Francois Emile
- Université Paris-Saclay, UVSQ, EA4340-BECCOH, Service de Pathologie, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Ambroise-Paré, France
| | - Didier Bouscary
- Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Service d'Hématologie clinique, Hôpital Cochin, Paris, France; Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016, Paris, France
| | - Barbara Burroni
- Service de pathologie, AP-HP, Hôpital Cochin, F-75014 Paris, France; Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, F-75006 Paris, France
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Ronen S, Keiser E, Collins KM, Aung PP, Nagarajan P, Tetzlaff MT, Curry JL, Ivan D, Prieto VG, Hymes S, Medeiros LJ, Torres-Cabala CA. Langerhans cell sarcoma involving skin and showing epidermotropism: A comprehensive review. J Cutan Pathol 2020; 48:547-557. [PMID: 32644218 DOI: 10.1111/cup.13803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/25/2020] [Accepted: 07/05/2020] [Indexed: 12/31/2022]
Abstract
Langerhans cell sarcoma (LCS) is rare and aggressive; patients have an overall survival rate of less than 50%. We present a 62-year-old man with a history of superficial spreading melanoma of the upper back with sentinel lymph node metastasis, Langerhans cell histiocytosis, and LCS. The patient presented with erythematous papules and scaly areas on his face, neck, arms, chest, abdomen, and legs. A skin biopsy revealed a proliferation of large neoplastic cells involving the dermis and with epidermotropism. These cells had atypical bean-shaped nuclei, with ample cytoplasm and abundant mitotic figures including atypical forms. Immunohistochemical studies showed the tumor to be diffusely positive for CD1a, S100 protein, and langerin (CD207) and negative for melanocytic markers. Some tumor cells were positive for cyclin D1. A diagnosis of LCS involving the skin was established. The present study is a very unusual case of LCS showing epidermotropism. The patient's history of metastatic melanoma posed additional challenges for diagnosis, underlying the need of immunophenotyping in these cases. Consensus for optimal standard therapy has not been established in LCS, and thus, early recognition is important since these neoplasms tend to recur and metastasize. LCS in skin is discussed and published cases are comprehensively reviewed.
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Affiliation(s)
- Shira Ronen
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Elizabeth Keiser
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Katrina M Collins
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Phyu P Aung
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Priyadharsini Nagarajan
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael T Tetzlaff
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jonathan L Curry
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Doina Ivan
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Victor G Prieto
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sharon Hymes
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carlos A Torres-Cabala
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Katsuragawa H, Yamada Y, Ishida Y, Kaku Y, Fujimoto M, Kataoka TR, Haga H. A case of Langerhans cell sarcoma on the scalp: Whole-exome sequencing reveals a role of ultraviolet in the pathogenesis. Pathol Int 2020; 70:881-887. [PMID: 33410565 DOI: 10.1111/pin.13007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 11/28/2022]
Abstract
Langerhans cell sarcoma (LCS) is a high-grade neoplasm with overtly malignant cytological features and a Langerhans cell phenotype. The underlying genetic features are poorly understood, and only a few alterations, such as those of the MARK pathway-related genes, CDKN2A and TP53 have been reported. Here we present a 70-year-old male with LCS on the scalp and pulmonary metastasis. The multinodular tumor, 3.0 cm in diameter, consisted of diffusely proliferated pleomorphic cells with numerous mitoses (53/10 HPFs). Immunohistochemically, the tumor cells were positive for CD1a, Langerin and PD-L1, and the Ki-67 labeling index was 50%. These pathological features were consistent with LCS, and were also observed in the metastatic tumor. Whole-exome sequencing revealed that both the primary and metastatic tumors harbored a large number of mutations (>20 mutations/megabase), with deletion of CDKN2A and TP53 mutation, and highlighted that the mutational signature was predominantly characteristic of ultraviolet (UV) exposure (W = 0.828). Our results suggest, for the first time, that DNA damage by UV could accumulate in Langerhans cells and play a role in the pathogenesis of LCS. The high mutational burden and PD-L1 expression in the tumor would provide a rationale for the use of immune checkpoint inhibitors for treatment of unresectable LCS.
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Affiliation(s)
| | - Yosuke Yamada
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Yoshihiro Ishida
- Department of Dermatology, Kyoto University Hospital, Kyoto, Japan
| | - Yo Kaku
- Department of Dermatology, Kyoto University Hospital, Kyoto, Japan
| | - Masakazu Fujimoto
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Tatsuki R Kataoka
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Hironori Haga
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
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Tella SH, Kommalapati A, Rech KL, Go RS, Goyal G. Incidence, Clinical Features, and Outcomes of Langerhans Cell Sarcoma in the United States. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2019; 19:441-446. [PMID: 31005630 DOI: 10.1016/j.clml.2019.03.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/22/2019] [Accepted: 03/25/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Limited knowledge exists on the incidence, treatment patterns, and long-term outcomes of Langerhans cell sarcoma (LCS) in the United States. PATIENTS AND METHODS We performed a retrospective study of LCS patients diagnosed between 2001 and 2014 using the Surveillance, Epidemiology, and End Results (SEER) and National Cancer Data Base (NCDB) databases. Incidence was calculated from SEER, and treatment patterns and outcomes were calculated from NCDB. RESULTS A total of 25 and 52 cases of LCS were reported to SEER and NCDB, respectively. The overall incidence of the disease was 0.2 per 10,000,000 and did not differ by race (P = .56) or sex (P = .33). The median age at diagnosis was 62 (range, 19-90) years. Of the 52 patients from NCDB, 20 (39%) received chemotherapy as first-line therapy, 24 (46%) received surgery, and 15 (29%) received radiotherapy. The 1-year overall survival (OS) rate was 62%, and the median OS was 19 months. After censoring the patients with bone marrow and reticuloendothelial system involvement, no significant difference in OS was noted between the patients who were managed with or without surgery (P = .75). Postsurgical radiation or chemotherapy were not associated with improvement in median OS (P = .25). Patients who were managed with radiotherapy had a better OS compared to those who received no radiotherapy (P = .03). CONCLUSION This dual-national registry study shows that LCS is extremely rare and has a poor prognosis. Radiotherapy may offer a survival advantage to patients with locoregional disease without bone marrow and reticuloendothelial system involvement.
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Affiliation(s)
- Sri Harsha Tella
- Department of Internal Medicine, University of South Carolina School of Medicine, Columbia, SC
| | - Anuhya Kommalapati
- Department of Internal Medicine, University of South Carolina School of Medicine, Columbia, SC
| | - Karen L Rech
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Ronald S Go
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Gaurav Goyal
- Division of Hematology, Mayo Clinic, Rochester, MN.
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