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Legarrea JMA, Alves HDS, Chaves RRM, Soares CD, Robinson L, van Heerden WFP, de Andrade BAB, Polti LF, de Souza SF, Gomez RS, de Cáceres CVBL, Vargas PA, Fonseca FP. Histiocytic sarcoma affecting the oral cavity: a clinical, pathologic and molecular study. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(24)00368-7. [PMID: 39048487 DOI: 10.1016/j.oooo.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/07/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE To investigate the clinicopathological, immunohistochemical and molecular features of histiocytic sarcomas affecting the oral cavity. METHODS Pathology files of two institutions were searched for cases of histiocytic sarcoma, and new H&E-stained slides and immunohistochemistry reactions evaluated for diagnosis confirmation. Molecular screening for KRAS and PIK3CA mutations was performed through polymerase chain reaction (PCR) followed by Sanger sequencing. BRAFp.V600E mutation was assessed by pyrosequencing. Clinical data regarding sex, age, tumor location, systemic manifestations, clinical presentation, follow-up time, treatment applied and status at last follow-up were collected from patients' pathology and medical files. RESULTS Three cases were retrieved during the period investigated (2000-2023). Two females and one male were affected, with a wide age range, involving the tongue, palate and gingiva. Histopathologically, the neoplasms presented as highly pleomorphic atypical cells distributed diffusely with infiltration of normal structures. All cases demonstrated histiocytic differentiation expressing CD68 and CD163, and a high Ki67 expression. Genetic mutations were evaluated in two cases. One case harboured BRAF-V600E mutation, but not in KRAS and PIK3CA, while the second case did not show mutation in BRAF-V600E, KRAS and PI3KCA. One patient was lost, and two patients died after eight and four months of follow-up. CONCLUSION Histiocytic sarcomas involving the oral cavity are extremely rare, and may represent dissemination of a systemic condition. It has an aggressive biological behaviour with a poor overall prognosis.
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Affiliation(s)
- Juan Manuel Arteaga Legarrea
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Humberto de Souza Alves
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Roberta Rayra Martins Chaves
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Liam Robinson
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Willie F P van Heerden
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; PathCare Vermaak Histopathology, Centurion, Pretoria, South Africa
| | | | - Lucas Fabian Polti
- Pathology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Silvia Ferreira de Souza
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Pablo Agustin Vargas
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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2
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Imataki O, Uemura M, Fujita H, Kadowaki N. Application of PD‑L1 blockade in refractory histiocytic sarcoma: A case report. Mol Clin Oncol 2022; 17:136. [PMID: 35949894 PMCID: PMC9353867 DOI: 10.3892/mco.2022.2569] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/22/2022] [Indexed: 11/22/2022] Open
Abstract
Histiocytic sarcoma (HS) is a rare hematological malignancy, which exhibits morphological and immunophenotypic features of histiocytes. A standard therapy for HS has not yet been established due to its rareness; therefore, disease control is not always possible. A multimodal treatment strategy has been suggested for HS. The present study reported on a case of a 43-year-old female patient who complained of left femoral pain, which was caused by left femoral bone mass. A biopsy of their left femoral bone tumor revealed that the patient had HS. Their sarcoma was localized in the femoral bone and was not considered to be curable, due to local infiltration of the bone tumor beyond the periosteum. The patient then underwent two types of HS-specific chemotherapy; however, both regimens were ineffective. As a result, they underwent radiation therapy at the sites of progressive disease. Because the HS cells of the patient expressed PD-L1, they were treated with nivolumab (240 mg/body, biweekly) for residual diseases in the right occipital bone, multiple lung nodules, intrapelvic right lymph node and primary site. Nivolumab treatment resulted in a complete response at all sites, with the exception of the primary site, which was confirmed by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography. The patient received additional nivolumab treatment as consolidation therapy for 1 year. In addition, residual disease of the femoral head was completely resected. The surgically resected refractory tumor revealed the tumor cells no longer pathologically expressed PD-L1 . In conclusion, for refractory and recurrent HS in which surgical resection is not appropriate, treatment with immune-checkpoint inhibitors, such as nivolumab, may be considered an optional but promising immunotherapy if the tumor histologically expresses PD-L1. The present study detected one of the refractory mechanisms of ICI treatment.
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Affiliation(s)
- Osamu Imataki
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Miki, Kagawa 761‑0793, Japan
| | - Makiko Uemura
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Miki, Kagawa 761‑0793, Japan
| | - Haruyuki Fujita
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Miki, Kagawa 761‑0793, Japan
| | - Norimitsu Kadowaki
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Miki, Kagawa 761‑0793, Japan
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3
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Bellalah A, korbi I, Ben Hammouda S, Achour A, Ben Abdeljelil N, Njima M, Daldoul A, Hadhri R, Njim L, Zakhama A. Small bowel and lung histiocytic sarcoma revealed by acute peritonitis: A case report with review of literature. Ann Med Surg (Lond) 2021; 68:102638. [PMID: 34381610 PMCID: PMC8339142 DOI: 10.1016/j.amsu.2021.102638] [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: 07/09/2021] [Revised: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Histiocytic sarcoma (HS) is a rare malignant neoplasm showing morphologic and immunohistochemical features of histiocytes. It is characterized typically by extranodal presentation and a poor clinical course, particularly in cases with disseminated disease. CASE PRESENTATION This report documents a case of bifocal and aggressive HS in small bowel and lung revealed by acute peritonitis in a 63-year-old man. CLINICAL DISCUSSION Despite its rarity, we believe that the correct diagnosis of HS is crucial for clinical treatment and prognostic prediction. CONCLUSION The collection of additional cases of HS are important to obtain further progress in prognosis and guide treatment decisions.
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Affiliation(s)
- Ahlem Bellalah
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Ibtissem korbi
- Department of Digestive Surgery, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Seifeddine Ben Hammouda
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Asma Achour
- Department of Radiology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Nouha Ben Abdeljelil
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Manel Njima
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Amira Daldoul
- Department of Carcinology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Rim Hadhri
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Leila Njim
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Abdelfatteh Zakhama
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
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Wehrmann S, Rudolph H, Ernst D, Siepmann T, Kaltofen D, Hänel M, Mirow L. Case Report: Eighteen Month Relapse- Free Survival Following Radical Multidisciplinary Oncological Treatment in a 68-Year-Old Male Patient With Histiocytic Sarcoma. Front Oncol 2021; 11:633215. [PMID: 34164336 PMCID: PMC8215356 DOI: 10.3389/fonc.2021.633215] [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: 11/24/2020] [Accepted: 05/13/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Histiocytic Sarcoma (HS) is a rare and aggressive malignancy, and patients can present with rapid tumor growth and invasion. The optimal diagnostic and therapeutic management is unknown since only a few cases have been published. Here we report a patient with histiocytic sarcoma of the right groin. Case A 68 year-old male patient presented to our hospital with suspicion of a superinfected atheroma of the right groin. Computed tomography showed an abdominal tumor of unknown entity. Detailed assessment including immunohistochemically evaluation of biopsy material confirmed HS. The patient underwent radical tumor resection including compartment-resection of the right thigh. During five additional cycles of chemotherapy over a period of 1.5 years he remained relapse-free. Summary Diagnostic work up and treatment of HS is challenging, as there is a paucity of clinical reports and lack of standard guidelines for care. In the present case report, aggressive multidisciplinary treatment resulted in good clinical outcome, however, further studies evaluating this approach in similar patients are needed.
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Affiliation(s)
- Stefan Wehrmann
- Department of General and Visceral Surgery, Klinikum Chemnitz gemeinnützige Gesellschaft mit beschränkter Haftung (gGmbH), Chemnitz, Germany
| | - Hagen Rudolph
- Department of General and Visceral Surgery, Klinikum Chemnitz gemeinnützige Gesellschaft mit beschränkter Haftung (gGmbH), Chemnitz, Germany
| | - Dominikus Ernst
- Department of General and Visceral Surgery, Klinikum Chemnitz gemeinnützige Gesellschaft mit beschränkter Haftung (gGmbH), Chemnitz, Germany
| | - Timo Siepmann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Dorothea Kaltofen
- Department of General and Visceral Surgery, Klinikum Chemnitz gemeinnützige Gesellschaft mit beschränkter Haftung (gGmbH), Chemnitz, Germany
| | - Mathias Hänel
- Department of Medical Oncology, Klinikum Chemnitz gemeinnützige Gesellschaft mit beschränkter Haftung (gGmbH), Chemnitz, Germany
| | - Lutz Mirow
- Department of General and Visceral Surgery, Klinikum Chemnitz gemeinnützige Gesellschaft mit beschränkter Haftung (gGmbH), Chemnitz, Germany
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5
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Massoth LR, Hung YP, Ferry JA, Hasserjian RP, Nardi V, Nielsen GP, Sadigh S, Venkataraman V, Selig M, Friedmann AM, Samore W, Killian JK, Milante R, Giessinger J, Foley-Peres K, Marcus C, Severson E, Duncan D, Sivakumar S, Ross JS, Desphande V, Ramkissoon SH, Vergilio JA, Louissaint A, Zukerberg LR, Williams EA. Histiocytic and Dendritic Cell Sarcomas of Hematopoietic Origin Share Targetable Genomic Alterations Distinct from Follicular Dendritic Cell Sarcoma. Oncologist 2021; 26:e1263-e1272. [PMID: 33904632 PMCID: PMC8265357 DOI: 10.1002/onco.13801] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/16/2021] [Indexed: 12/18/2022] Open
Abstract
Background Histiocytic and dendritic cell neoplasms are a diverse group of tumors arising from monocytic or dendritic cell lineage. Whereas the genomic features for Langerhans cell histiocytosis and Erdheim‐Chester disease have been well described, other less common and often aggressive tumors in this broad category remain poorly characterized, and comparison studies across the World Health Organization diagnostic categories are lacking. Methods Tumor samples from a total of 102 patient cases within four major subtypes of malignant histiocytic and dendritic cell neoplasms, including 44 follicular dendritic cell sarcomas (FDCSs), 41 histiocytic sarcomas (HSs), 7 interdigitating dendritic cell sarcomas (IDCSs), and 10 Langerhans cell sarcomas (LCSs), underwent hybridization capture with analysis of up to 406 cancer‐related genes. Results Among the entire cohort of 102 patients, CDKN2A mutations were most frequent across subtypes and made up 32% of cases, followed by TP53 mutations (22%). Mitogen‐activated protein kinase (MAPK) pathway mutations were present and enriched among the malignant histiocytosis (M) group (HS, IDCS, and LCS) but absent in FDCS (72% vs. 0%; p < .0001). In contrast, NF‐κB pathway mutations were frequent in FDCSs but rare in M group histiocytoses (61% vs. 12%; p < .0001). Tumor mutational burden was significantly higher in M group histiocytoses as compared with FDCSs (median 4.0/Mb vs. 2.4/Mb; p = .012). We also describe a pediatric patient with recurrent secondary histiocytic sarcoma treated with targeted therapy and interrogated by molecular analysis to identify mechanisms of therapeutic resistance. Conclusion A total of 42 patient tumors (41%) harbored pathogenic mutations that were potentially targetable by approved and/or investigative therapies. Our findings highlight the potential value of molecular testing to enable precise tumor classification, identify candidate oncogenic drivers, and define personalized therapeutic options for patients with these aggressive tumors. Implications for Practice This study presents comprehensive genomic profiling results on 102 patient cases within four major subtypes of malignant histiocytic and dendritic cell neoplasms, including 44 follicular dendritic cell sarcomas (FDCSs), 41 histiocytic sarcomas (HSs), 7 interdigitating dendritic cell sarcomas (IDCSs), and 10 Langerhans cell sarcomas (LCSs). MAPK pathway mutations were present and enriched among the malignant histiocytosis (M) group (HS, IDCS, and LCS) but absent in FDCSs. In contrast, NF‐κB pathway mutations were frequent in FDCSs but rare in M group histiocytosis. A total of 42 patient tumors (41%) harbored pathogenic mutations that were potentially targetable by approved and/or investigative therapies. Histiocytic and dendritic cell neoplasms are a diverse group of tumors arising from the monocytic or dendritic cell lineage. This article presents the molecular characteristics of the four major subtypes of malignant histiocytic and dendritic cell neoplasms, focusing on genomic alterations that could represent therapeutic targets.
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Affiliation(s)
- Lucas R Massoth
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Yin P Hung
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Judith A Ferry
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Robert P Hasserjian
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Valentina Nardi
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - G Petur Nielsen
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Sam Sadigh
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Vinayak Venkataraman
- Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Martin Selig
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Alison M Friedmann
- Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Wesley Samore
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Riza Milante
- Department of Dermatology, Jose R. Reyes Memorial Medical Center, Manila, Philippines
| | - Joseph Giessinger
- A.T. Still University School of Osteopathic Medicine, Mesa, Arizona, USA
| | - Kathleen Foley-Peres
- Department of Biology, Bristol Community College, Fall River, Massachusetts, USA
| | - Chelsea Marcus
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA
| | - Eric Severson
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA
| | - Daniel Duncan
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA
| | | | - Jeffrey S Ross
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA.,Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Vikram Desphande
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Shakti H Ramkissoon
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA.,Wake Forest Comprehensive Cancer Center and Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Abner Louissaint
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Lawrence R Zukerberg
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Erik A Williams
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA.,Department of Pathology, Department of Dermatology, UCSF Dermatopathology Service, University of California San Francisco, San Francisco, California, USA
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6
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Ajabnoor R, Bell PD, Schiffman S, Carmody E, Monu J, Wang X. Histiocytic Sarcoma Arising From a Long Bone: Report of Two Cases. Int J Surg Pathol 2021; 29:752-758. [PMID: 33750231 DOI: 10.1177/1066896921996464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Histiocytic sarcoma is a rare, but aggressive malignant neoplasm of monocyte/macrophage lineage with a wide age distribution. Bone involvement is exceedingly rarer compared to the lymph node, skin, and soft tissue, and no long bone involvement has been reported in the English literature. We here report 2 cases of histiocytic sarcoma involving the long bone: one from the femur of a 77-year-old female, status post the placement of an intramedullary nail for subtrochanteric hip fracture; the other from the radius of a 3-year-old female with no significant medical history. Radiologic imaging showed highly destructive lesions in both cases with soft-tissue extension. Microscopy in both cases showed sheets of polygonal mononuclear cells with abundant eosinophilic cytoplasm, prominent nucleoli, and frequent mitosis. Hemophagocytosis were also identified. Immunohistochemistry showed that the lesional cells were strongly diffusely positive for CD68 and CD163. The first patient deteriorated rapidly, despite the aggressive treatment of amputation and chemotherapy. However, the second patient is disease free 36 months post the treatment of amputation only. We conclude that the long bone could be the primary site of histiocytic sarcoma. Its prognosis could be very variable and it is difficult to predict its behavior based on morphological evaluation only.
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Affiliation(s)
- Rana Ajabnoor
- 6923University of Rochester Medical Center, Rochester, USA.,37848King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Phoenix D Bell
- 6923University of Rochester Medical Center, Rochester, USA
| | | | - Emily Carmody
- 6923University of Rochester Medical Center, Rochester, USA
| | - Johnny Monu
- 6923University of Rochester Medical Center, Rochester, USA
| | - Xi Wang
- 6923University of Rochester Medical Center, Rochester, USA
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7
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Histiocytic Sarcoma: Challenging Course, Dismal Outcome. Diagnostics (Basel) 2021; 11:diagnostics11020310. [PMID: 33671860 PMCID: PMC7918796 DOI: 10.3390/diagnostics11020310] [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: 01/18/2021] [Revised: 02/09/2021] [Accepted: 02/13/2021] [Indexed: 11/17/2022] Open
Abstract
Histiocytic sarcoma (HS) is a rare hematopoietic neoplasm derived from non-Langerhans histiocytic cells of the monocyte/macrophage system. With an incidence of 0.17/million individuals and a slight male preference, HS presents with a wide age distribution. Most commonly, it occurs as a primary malignancy. In approximately 25% of the cases a presumed transdifferentiation of a preexisting hematolymphoid disorder can be demonstrated. The clinical presentation varies from a localized solitary mass to severe disseminated disease often with extranodal involvement including skin, soft tissue, the gastrointestinal tract and the hematopoietic system. Systemic symptoms in terms of weight loss, fever and night sweats often occur. The diagnostic work-up of HS is extremely challenging due to the rarity of the disease as well as a wide differential diagnosis in terms of a histologic overlap with diverse mimics. No standardized treatment for HS exists and especially in a disseminated disease the clinical course is overly aggressive with a dismal outcome. The median overall survival from the time of diagnosis is approximately six months. We report a 43-year-old previously healthy Caucasian male admitted to our hospitals with abdominal pain and a feeling of fatigue. We demonstrate both the challenges of a correct diagnosis and an effective treatment as well as the aggressive nature of histiocytic sarcoma.
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8
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Esmati E, Kolahdouzan K. Metastatic follicular dendritic cell sarcoma treated with gemcitabine plus docetaxel with an outstanding survival: A case report and review of literature. Clin Case Rep 2021; 9:473-476. [PMID: 33489199 PMCID: PMC7813082 DOI: 10.1002/ccr3.3560] [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: 07/28/2020] [Revised: 10/06/2020] [Accepted: 11/01/2020] [Indexed: 01/17/2023] Open
Abstract
Follicular dendritic cell sarcoma responded dramatically to chemotherapy with gemcitabine and docetaxel.
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Affiliation(s)
- Ebrahim Esmati
- Radiation Oncology Research CenterImam Khomeini Hospital ComplexCancer InstituteTehran University of Medical SciencesTehranIran
| | - Kasra Kolahdouzan
- Radiation Oncology Research CenterImam Khomeini Hospital ComplexCancer InstituteTehran University of Medical SciencesTehranIran
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9
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Moullet B, Kolev M, Ebner L, Langer R, Gräni C, Obmann V, Maurer M, Semmo N, Christe A, Huber AT. Adult form of Langerhans cell histiocytosis with pulmonary and hepatic involvement mimicking malignancy in a patient with chronic hepatitis C infection. Radiol Case Rep 2020; 16:327-333. [PMID: 33318775 PMCID: PMC7724096 DOI: 10.1016/j.radcr.2020.11.022] [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: 08/12/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 11/28/2022] Open
Abstract
Langerhans cell histiocytosis (LCH) is a myeloid neoplasm with inflammatory properties. There are few published reports of adult LCH with liver involvement, which is still poorly understood, but shows high morbidity and mortality. We report a case of a 37-year-old woman suffering from hepatitis C showing a LCH affecting the lung as well as the liver. Consistent with histology, we found an early stage of a proliferative/granulomatous phase of hepatobiliary LCH, whereas pulmonary findings showed a nodular stage of adult pulmonary LCH. Although hepatocellular carcinoma is a common malignancy in patients suffering from hepatitis C, it is crucial to keep in mind differential diagnosis for newly appearing liver lesions.
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Affiliation(s)
- Barbara Moullet
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse 10, Inselspital, 3010, Bern, Switzerland
| | - Mirjam Kolev
- Hepatology, Department of Visceral Surgery and Medicine, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Lukas Ebner
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse 10, Inselspital, 3010, Bern, Switzerland
| | - Rupert Langer
- Department of Pathology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Gräni
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Verena Obmann
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse 10, Inselspital, 3010, Bern, Switzerland
| | - Martin Maurer
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse 10, Inselspital, 3010, Bern, Switzerland
| | - Nasser Semmo
- Hepatology, Department of Visceral Surgery and Medicine, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Christe
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse 10, Inselspital, 3010, Bern, Switzerland
| | - Adrian Thomas Huber
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse 10, Inselspital, 3010, Bern, Switzerland
- Corresponding author.
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10
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Okada K, Takahara T, Suzuki Y, Kohno K, Sakakibara A, Satou A, Takahashi E, Nakamura S. Histiocytic and dendritic cell neoplasms: Reappraisal of a Japanese series based on t(14;18) and neoplastic PD-L1 expression. Pathol Int 2020; 71:24-32. [PMID: 33238073 DOI: 10.1111/pin.13044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/20/2020] [Indexed: 11/27/2022]
Abstract
Histiocytic and dendritic cell (H/DC) neoplasms are heterogeneous, originating from myeloid- or stromal-derived cells. Multiple reports describe the cross-lineage transdifferentiation of neoplastic B cells into H/DC neoplasms. Most such cases are from Western countries, and rarely from Japan or East Asia. Here we report 17 cases of H/DC neoplasms in Japanese patients, with analysis of t(14;18) by fluorescence in situ hybridization, and of neoplastic programmed death-ligand 1 (PD-L1) expression by immunostaining (clones SP142, E1J2J, and 28-8). These 17 cases were diagnosed according to the 2017 World Health Organization (WHO) classification, and included two histiocytic sarcomas (HS), two interdigitating cell (IDC) sarcomas, one Langerhans cell sarcoma, two dendritic cell sarcomas, and 10 follicular dendritic cell (FDC) sarcomas. No case had any past history of follicular lymphoma (FL). Two cases of HS and one IDC sarcoma, all of which were myeloid-driven, were found to exhibit t(14;18). In the latter case, at 30 months after IDC sarcoma diagnosis, FL development was detected. Three (30%) FDC sarcoma cases exhibited neoplastic PD-L1 expression with all the three PD-L1 antibody clones. This is the first report of t(14;18) and neoplastic PD-L1 expression on H/DC neoplasms among Japanese patients, each of which appeared to be associated with HS and FDC sarcoma, respectively.
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Affiliation(s)
- Kanae Okada
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan
| | - Taishi Takahara
- Department of Surgical Pathology, Aichi Medical University Hospital, Aichi, Japan
| | - Yuka Suzuki
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan
| | - Kei Kohno
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Ayako Sakakibara
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan
| | - Akira Satou
- Department of Surgical Pathology, Aichi Medical University Hospital, Aichi, Japan
| | - Emiko Takahashi
- Department of Surgical Pathology, Aichi Medical University Hospital, Aichi, Japan
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan
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11
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Hirabayashi M, Chambers JK, Sumi A, Harada K, Haritani M, Omachi T, Kobayashi T, Nakayama H, Uchida K. Immunophenotyping of Nonneoplastic and Neoplastic Histiocytes in Cats and Characterization of a Novel Cell Line Derived From Feline Progressive Histiocytosis. Vet Pathol 2020; 57:758-773. [PMID: 32885737 DOI: 10.1177/0300985820953538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Histiocytic proliferative diseases are rare in cats, and their pathogenesis is poorly understood. In the present study, 25 cases of histiocytic sarcoma (HS) and 6 of feline progressive histiocytosis (FPH) were examined, and survival times were recorded in 19 cases. The immunophenotypes of tumor cells in these cases as well as of nonneoplastic feline histiocytes were characterized using formalin-fixed, paraffin-embedded tissues. An FPH cell line (AS-FPH01) and xenotransplant mouse model of FPH were also established. The median survival time of HS (150 days) was significantly shorter than that of FPH (470 days). Immunohistochemically, nonneoplastic histiocytes were immunopositive for various combinations of Iba-1, HLA-DR, E-cadherin, CD204, CD163, CD208, and MAC387. By immunohistochemistry, dermal interstitial dendritic cells (iDCs) and macrophages were CD204+/E-cadherin-, while epidermal Langerhans cells (LCs) were CD204-/E-cadherin+. Neoplastic cells of 4 FPH and 18 HS were CD204+/E-cadherin- (iDC/macrophage immunophenotype), while 2 FPH and 2 HS were CD204-/E-cadherin+ (LC immunophenotype), and 5 HS were CD204+/E-cadherin+ (LC-like cell immunophenotype). Furthermore, immunohistochemical and western blot analyses of AS-FPH01 cells derived from E-cadherin-negative FPH revealed that cultured cells were immunopositive for both CD204 and E-cadherin in vitro and in vivo. These results indicate that the neoplastic cells of feline HS and FPH were variably positive for iDC/macrophage and LC markers, and their immunophenotype changed in different microenvironments. The novel cell line established in the present study may serve as an experimental model of FPH that will enable further molecular and therapeutic studies on this disease.
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Affiliation(s)
| | | | | | - Kei Harada
- Japan Small Animal Cancer Center, Tokorozawa, Saitama, Japan
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12
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Kim HM, Yang WI, Lyu CJ, Hahn SM, Yoon SO. Descriptive Analysis of Histiocytic and Dendritic Cell Neoplasms: A Single-Institution Experience. Yonsei Med J 2020; 61:774-779. [PMID: 32882761 PMCID: PMC7471072 DOI: 10.3349/ymj.2020.61.9.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/21/2020] [Accepted: 08/06/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Histiocytic and dendritic cell neoplasms are rare hematologic tumors. This study aimed to describe the epidemiologic features of the entire spectrum of histiocytic and dendritic cell neoplasms, including clinicopathological variables and patient outcomes. MATERIALS AND METHODS We comprehensively reviewed 274 patients who were diagnosed with histiocytic and dendritic neoplasms at Severance Hospital, Seoul, South Korea between 1995 and 2018. RESULTS The most common neoplasm was Langerhans cell histiocytosis (LCH), followed by dermal xanthogranuloma. Among non-LCH sarcomas, histiocytic sarcoma (HS) showed a relatively high prevalence, followed by follicular dendritic cell sarcoma (FDCS). Disseminated juvenile xanthogranuloma (DJG), Erdheim-Chester disease (ECD), indeterminate dendritic cell tumor (IDCT), and interdigitating dendritic cell sarcoma (IDCS) rarely occurred. Generally, these tumors presented in childhood, although the non-LCH sarcoma (HS/FDCS/IDCS/IDCT) group of tumors and ECD occurred in late adulthood. Multiorgan involvement and advanced Ann-Arbor stage, as well as recurrence and death of disease, were not uncommon. The non-LCH sarcoma group had the worst overall survival, compared to the DJG, ECD, and LCH groups. CONCLUSION Our findings indicate that histiocytic and dendritic cell neoplasms exhibit heterogeneous epidemiologic characteristics and that some patients may have unfavorable outcomes, especially those with non-LCH sarcoma.
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Affiliation(s)
- Hye Min Kim
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea
| | - Woo Ick Yang
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea
| | - Chuhl Joo Lyu
- Department of Pediatrics, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea
| | - Seung Min Hahn
- Department of Pediatrics, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea
| | - Sun Och Yoon
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea.
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13
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Abstract
Histiocytic sarcoma, a rare malignant neoplasm showing morphologic and immunophenotypic features of histiocytes, is characterized typically by extranodal presentation and a dismal clinical course, particularly in patients with disseminated disease. A history of hematolymphoid disorder can be identified in a subset of patients, suggesting transdifferentiation of a preexisting hematolymphoid neoplasm in its pathogenesis. The differential diagnosis of histiocytic sarcoma includes various lymphomas, other histiocytic and dendritic cell neoplasms, carcinomas, melanomas, and pleomorphic sarcomas. Given its rarity and histologic overlap with diverse mimics, the diagnosis of histiocytic sarcoma can be extremely challenging. Recognition of morphologic clues, as well as judicious application of immunohistochemical markers to confirm its histiocytic lineage and to exclude mimics, is crucial for the diagnosis. Recent molecular studies by targeted next-generation sequencing identified recurrent alterations in the mitogen-activated protein (MAP) kinase pathway and chromatin regulators in the pathogenesis of histiocytic sarcoma and may suggest possible therapeutic targets.
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Affiliation(s)
- Yin P. Hung
- From the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (Dr Hung); and Fine Needle Aspiration Service, Brigham and Women's Hospital, Boston, Massachusetts, the Department of Pathology, Harvard Medical School, Boston, Massacusetts, and Bone and Soft Tissue Pathology Service, Dana Farber Cancer Institute, Boston, Massachusetts (Dr Qian)
| | - Xiaohua Qian
- From the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (Dr Hung); and Fine Needle Aspiration Service, Brigham and Women's Hospital, Boston, Massachusetts, the Department of Pathology, Harvard Medical School, Boston, Massacusetts, and Bone and Soft Tissue Pathology Service, Dana Farber Cancer Institute, Boston, Massachusetts (Dr Qian)
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14
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Takada M, Smyth LA, Hix JM, Corner SM, Kiupel M, Yuzbasiyan-Gurkan V. Development of an Orthotopic Intrasplenic Xenograft Mouse Model of Canine Histiocytic Sarcoma and Its Use in Evaluating the Efficacy of Treatment with Dasatinib. Comp Med 2019; 69:22-28. [PMID: 30717820 DOI: 10.30802/aalas-cm-18-000065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Canine histiocytic sarcoma is a highly aggressive and metastatic hematopoietic neoplasm that responds poorly to currently available treatment regimens. Our goal was to establish a clinically relevant xenograft mouse model to assess the preclinical efficacy of novel cancer treatment protocols for histiocytic sarcoma. We developed an intrasplenic xenograft mouse model characterized by consistent tumor growth and development of metastasis to the liver and other abdominal organs. This model represents the metastatic or disseminated form of canine histiocytic sarcoma, which is considered the most clinically challenging form of the disease. Transfection of tumor cells with a luciferase vector supported the use of in vivo bioluminescence imaging to track tumor progression over time and to assess the response of this murine model to novel chemotherapeutic agents. Dasatinib treatment of the mice with intrasplenic xenografts decreased tumor growth and increased survival times, compared with mice treated with vehicle only. Our findings indicate the potential of dasatinib for the treatment of histiocytic sarcoma in dogs and for similar diseases in humans. These results warrant additional studies to clinically test the efficacy of dasatinib in dogs with histiocytic sarcoma.
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Affiliation(s)
- Marilia Takada
- Comparative Medicine and Integrative Biology Program, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin
| | - Lauren A Smyth
- Comparative Medicine and Integrative Biology Program, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Jeremy Ml Hix
- Department of Radiology, Comparative Medicine and Integrative Biology Program, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Sarah M Corner
- Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Matti Kiupel
- Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Vilma Yuzbasiyan-Gurkan
- Comparative Medicine and Integrative Biology Program, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan;,
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15
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Indeterminate Cell Histiocytosis – Case Report and Review of Literature. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2018. [DOI: 10.2478/sjdv-2018-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction. Indeterminate cell histiocytosis is a rare proliferative disorder of indeterminate dendritic cells, reported in only 50 case reports so far. It is clinically presented as yellow, red or brown papules and nodules that appear in otherwise healthy adult individuals. Indeterminate cells are distinct dendritic cells of the skin that have ultrastructural similarities to the epidermal Langerhans cells but do not contain the characteristic Birbeck’s granules and they are also langerin-negative, unlike LCH. Indeterminate cell histiocytosis is an exceptional entity with variable clinical, histopathologic or immunohistochemical findings, sharing morphologic and immunophenotypic features with both Langerhans- and non-Langerhans cell histiocytoses. Case Report. We present a case of indeterminate histiocytosis in a 77-year-old man with 3-year history of asymptomatic, multiple reddish and brown papules and nodules over the entire body, including the oral mucosa. Skin biopsy was done, and histopathological analysis with immunohistochemistry was performed. The positive ICH staining of cells for CD68, CD1a, and S-100 enabled us to diagnose ICH in our patient. Also, BRAF V600E mutation was detected in tumor tissue. The treatment was started with methotrexate that was effective for 6 months, but due to the disease recurrence, further therapy with thalidomide was advised, without effect. Conclusion. Indeterminate histiocytosis is a rare disease, therefore no standardized treatment has been established and the treatment options are limited.
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16
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Shimono J, Miyoshi H, Arakawa F, Abe H, Miyagishima T, Akiba J, Teshima T, Ohshima K. Synchronous case of follicular lymphoma and Langerhans cell sarcoma in the same lymph node. Pathol Int 2018; 68:614-617. [DOI: 10.1111/pin.12722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/29/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Joji Shimono
- Department of Pathology; Kurume University; School of Medicine Kurume Japan
- Department of Hematology; Hokkaido University Faculty of Medicine; Sapporo Japan
| | - Hiroaki Miyoshi
- Department of Pathology; Kurume University; School of Medicine Kurume Japan
| | - Fumiko Arakawa
- Department of Pathology; Kurume University; School of Medicine Kurume Japan
| | - Hideyuki Abe
- Department of Diagnostic Pathology; Kurume University, School of Medicine; Kurume Japan
| | | | - Jun Akiba
- Department of Diagnostic Pathology; Kurume University, School of Medicine; Kurume Japan
| | - Takanori Teshima
- Department of Hematology; Hokkaido University Faculty of Medicine; Sapporo Japan
| | - Koichi Ohshima
- Department of Pathology; Kurume University; School of Medicine Kurume Japan
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17
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Takada M, Hix JML, Corner S, Schall PZ, Kiupel M, Yuzbasiyan-Gurkan V. Targeting MEK in a Translational Model of Histiocytic Sarcoma. Mol Cancer Ther 2018; 17:2439-2450. [PMID: 30135215 DOI: 10.1158/1535-7163.mct-17-1273] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/09/2018] [Accepted: 08/16/2018] [Indexed: 12/25/2022]
Abstract
Histiocytic sarcoma in humans is an aggressive orphan disease with a poor prognosis as treatment options are limited. Dogs are the only species that spontaneously develops histiocytic sarcoma with an appreciable frequency, and may have value as a translational model system. In the current study, high-throughput drug screening utilizing histiocytic sarcoma cells isolated from canine neoplasms identified these cells as particularly sensitive to a MEK inhibitor, trametinib. One of the canine cell lines carries a mutation in PTPN11 (E76K), and another one in KRAS (Q61H), which are associated with the activation of oncogenic MAPK signaling. Both mutations were previously reported in human histiocytic sarcoma. Trametinib inhibited sensitive cell lines by promoting cell apoptosis, indicated by a significant increase in caspase 3/7. Furthermore, in vitro findings were successfully recapitulated in an intrasplenic orthotopic xenograft mouse model, which represents a disseminated aggressive form of histiocytic sarcoma. Mice with histiocytic sarcoma xenograft neoplasms that were treated with trametinib had significantly longer survival times. Target engagement was validated as activity of ERK, downstream of MEK, was significantly downregulated in neoplasms of treated mice. Additionally, trametinib was found in plasma and neoplastic tissues within projected therapeutic levels. These findings demonstrate that in dogs, histiocytic sarcoma may be associated with a dysfunctional MAPK pathway, at least in some cases, and may be effectively targeted through MEK inhibition. Clinical trials to test safety and efficacy of trametinib in dogs with histiocytic sarcoma are warranted, and may provide valuable translational information to similar diseases in humans. Mol Cancer Ther; 17(11); 2439-50. ©2018 AACR.
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Affiliation(s)
- Marilia Takada
- Comparative Medicine and Integrative Biology Program, Michigan State University, East Lansing, Michigan
| | - Jeremy M L Hix
- Department of Radiology, Michigan State University, East Lansing, Michigan
| | - Sarah Corner
- Comparative Medicine and Integrative Biology Program, Michigan State University, East Lansing, Michigan
| | - Peter Z Schall
- Comparative Medicine and Integrative Biology Program, Michigan State University, East Lansing, Michigan
| | - Matti Kiupel
- Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, Michigan
| | - Vilma Yuzbasiyan-Gurkan
- Comparative Medicine and Integrative Biology Program, Michigan State University, East Lansing, Michigan.
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