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Tang Z, Wang X, Xia Z, Wang Z, Zhao Y, Liu Y. Case Report: Multicentric Reticulohistiocytosis Associated With Posterior Mediastinal Adenosquamous Carcinoma, Antinuclear Antibody Positivity and Lupus Anticoagulant Positivity. Front Immunol 2022; 12:749669. [PMID: 35069525 PMCID: PMC8777097 DOI: 10.3389/fimmu.2021.749669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/13/2021] [Indexed: 02/05/2023] Open
Abstract
Multicentric reticulohistiocytosis (MRH) is a rare systemic disease of non-Langerhans cell histiocytosis. A number of studies in the literature have documented that it can coexist with malignancy or autoimmune disease, making it difficult to determine the most appropriate therapy. Here, we present a case study of MRH associated with posterior mediastinal adenosquamous carcinoma along with antinuclear antibody positivity and lupus anticoagulant positivity. The patient experienced 6 months of clinical benefit after surgical resection and chemoradiotherapy of the mediastinal malignancy. This case adds to the available literature on multicentric reticulohistiocytosis associated with different types of malignancy and provides supplementary clinical data on the coexistence of this syndrome with malignancy and immune system abnormalities. To the best of our knowledge, this is the first case study describing MRH accompanied by posterior mediastinal adenosquamous carcinoma and lupus anticoagulant positivity. The unknown aetiology and polymorphic clinical presentation of MRH warrants further investigation.
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Affiliation(s)
- Ziyi Tang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiangpeng Wang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Zijing Xia
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhongming Wang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Zhao
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Liu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
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Papageorgiou SG, Divane A, Roumelioti M, Kottaridi C, Bouchla A, Georgakopoulos A, Ieremiadou F, Daraki A, Bazani E, Thomopoulos TP, Chatziioannou S, Mavrogenis A, Panayiotidis P, Panayiotides IG, Pappa V, Foukas PG. Erdheim-Chester Disease and Acute Myeloid Leukemia with Mutated NPM1 in a Patient with Clonal Hematopoiesis: A Case Report. Onco Targets Ther 2020; 13:11689-11695. [PMID: 33235460 PMCID: PMC7678692 DOI: 10.2147/ott.s276497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/20/2020] [Indexed: 12/02/2022] Open
Abstract
Background Erdheim–Chester Disease (ECD) is a clonal non-Langerhans histiocytosis, classified as a macrophage-dendritic cell neoplasm in the 2016 WHO classification. The exact cell of origin of ECD is unknown, although some limited evidence suggests that it arises from myeloid progenitors. Case Presentation A 43-year-old patient, diagnosed with BRAFV600E mutated ECD, developed NPM1+/FLT3+ acute myeloid leukemia (AML) with wild-type BRAF, 15 months after the initial ECD diagnosis. The patient received intensive chemotherapy plus midostaurin, followed by midostaurin maintenance. Six months into maintenance, the patient remains in complete remission with low-level measurable residual disease, whereas ECD shows a sustained partial metabolic response. Molecular karyotype at several distinct timepoints, namely ECD diagnosis, AML diagnosis, and following treatment of AML, highlighted a molecular signature, indicative of a persistent, underlying clonal hematopoiesis. Conclusion This case report suggests that ECD and AML might represent an expansion of two distinct clones in a background of clonal hematopoiesis, indicating their shared origin. Moreover, molecular karyotype might serve as a strong, inexpensive tool for revealing clonal hematopoiesis in cases of negative targeted next-generation sequencing. Finally, the moderate response of ECD to midostaurin suggests that kinase inhibition might have a potential role in ECD treatment.
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Affiliation(s)
- Sotirios G Papageorgiou
- 2nd Department of Internal Medicine and Research Unit, Hematology Unit, University General Hospital "Attikon", Haidari, Athens, Greece
| | - Aspasia Divane
- "LIFE CODE" Private Diagnostic Laboratory, Medical Ltd., Athens, Greece
| | - Maria Roumelioti
- 1st Department of Propaedeutic Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Christine Kottaridi
- 2nd Department of Pathology, National and Kapodistrian University of Athens, Medical School, University General Hospital "Attikon", Haidari, Athens, Greece
| | - Anthi Bouchla
- 2nd Department of Internal Medicine and Research Unit, Hematology Unit, University General Hospital "Attikon", Haidari, Athens, Greece
| | - Alexandros Georgakopoulos
- 2nd Department of Radiology, Nuclear Medicine Section, National and Kapodistrian University of Athens, University General Hospital "Attikon", Haidari, Athens, Greece
| | - Fotini Ieremiadou
- "LIFE CODE" Private Diagnostic Laboratory, Medical Ltd., Athens, Greece
| | - Aggeliki Daraki
- "LIFE CODE" Private Diagnostic Laboratory, Medical Ltd., Athens, Greece
| | - Efthymia Bazani
- 2nd Department of Internal Medicine and Research Unit, Hematology Unit, University General Hospital "Attikon", Haidari, Athens, Greece
| | - Thomas P Thomopoulos
- 2nd Department of Internal Medicine and Research Unit, Hematology Unit, University General Hospital "Attikon", Haidari, Athens, Greece
| | - Sofia Chatziioannou
- 2nd Department of Radiology, Nuclear Medicine Section, National and Kapodistrian University of Athens, University General Hospital "Attikon", Haidari, Athens, Greece.,Nuclear Medicine Section, Biomedical Research Foundation Academy of Athens, BRFAA, Athens, Greece
| | - Andreas Mavrogenis
- 1st Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, University General Hospital "Attikon", Haidari, Athens, Greece
| | - Panayiotis Panayiotidis
- 1st Department of Propaedeutic Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis G Panayiotides
- 2nd Department of Pathology, National and Kapodistrian University of Athens, Medical School, University General Hospital "Attikon", Haidari, Athens, Greece
| | - Vasiliki Pappa
- 2nd Department of Internal Medicine and Research Unit, Hematology Unit, University General Hospital "Attikon", Haidari, Athens, Greece
| | - Periklis G Foukas
- 2nd Department of Pathology, National and Kapodistrian University of Athens, Medical School, University General Hospital "Attikon", Haidari, Athens, Greece
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