1
|
Gan M, He X, Zheng X. FDG PET/CT Imaging of Liver and Spleen Histiocytic Sarcoma. Clin Nucl Med 2024; 49:272-273. [PMID: 38306379 DOI: 10.1097/rlu.0000000000005043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
ABSTRACT Histiocytic sarcoma is a tumor of the lymphohematopoietic system characterized by macrophage morphology and immunophenotype. Here, we report FDG PET/CT images of a 50-year-old man with coexisting histiocytic sarcoma of the liver and spleen. Images showed multiple enhanced uptake lesions of FDG in both the liver and spleen. Ultimately, histiocytic sarcoma was confirmed by the biopsy histopathology.
Collapse
Affiliation(s)
| | - Xiaoxiao He
- Nuclear Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | | |
Collapse
|
2
|
Kurimoto T, Goto T, Yasuda T, Yoshioka H. Histiocytic sarcoma of the palate: a case report. Int J Oral Maxillofac Surg 2023; 52:1225-1229. [PMID: 37643937 DOI: 10.1016/j.ijom.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/18/2023] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
Histiocytic sarcoma is a malignant proliferation of cells that exhibit morphological and immunophenotypic features of mature histiocytes. Owing to its rarity, its clinical features and standard treatment have not yet been established. This report describes a case of histiocytic sarcoma of the palate that developed in a 76-year-old man, the first report of an intraoral histiocytic sarcoma. An extended resection was performed; however, establishing the excision line was extremely difficult because assessing the tumour boundary on imaging was challenging and the tumour underwent dynamic gross morphological changes following biopsy. Complete resection is required to obtain a favourable prognosis for high-grade tumours with indistinct borders. In this case, an intraoperative rapid examination with frozen section analysis was performed along the planned excision line to completely resect the tumours exhibiting such behaviour. At 28 months postoperatively, the patient demonstrated no recurrence or metastasis; however, he is under careful monitoring.
Collapse
Affiliation(s)
- T Kurimoto
- Department of Dentistry and Oral & Maxillofacial Surgery, Osaka Rosai Hospital, Sakai, Osaka, Japan.
| | - T Goto
- Department of Pathology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - T Yasuda
- Department of Dentistry and Oral & Maxillofacial Surgery, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - H Yoshioka
- Department of Dentistry and Oral & Maxillofacial Surgery, Osaka Rosai Hospital, Sakai, Osaka, Japan
| |
Collapse
|
3
|
Nguyen LT, Pham GH, Vu PT, Yi HG. Favorable outcome of a histiocytic sarcoma patient treated with immune checkpoint inhibitor: a case report. Ann Med Surg (Lond) 2023; 85:6274-6278. [PMID: 38098600 PMCID: PMC10718375 DOI: 10.1097/ms9.0000000000001446] [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: 07/25/2023] [Accepted: 10/18/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction and Importance Histiocytic sarcoma (HS) is an extremely rare malignancy in which there has been no standard treatment approach. Some preclinical studies have provided rationales for the application of immunotherapy in advanced HS. Case Presentation The authors reported a case of a 61-year-old patient with metastatic HS who had a rapid progression on ifosfamide, carboplatin, and etoposide chemotherapy. The authors performed PD-L1 testing, which showed a strong positivity in 90% of tumor cells. The patient was then treated with pembrolizumab 200 mg every 3 weeks. He refused palliative radiotherapy. A dramatic response in all sites was recorded on the PET-CT scan after three cycles. He was maintained on pembrolizumab, reaching over 30 months without disease progression. Clinical Discussion Recent molecular data suggests there could be a role of immunotherapy in HS. In our patient, the disease was refractory to chemotherapy and pembrolizumab has been given based on the strong PD-L1 expression. Response to immunotherapy has also been recorded in several cases with malignant histiocytic neoplasm. Conclusion Immunotherapy might bring sustained disease remission in PD-L1 high expression HS and further studies evaluating the role of immune checkpoint inhibitor in this disease are warranted.
Collapse
Affiliation(s)
- Long Thanh Nguyen
- Department of Medical Oncology No. 6, Vietnam National Cancer Hospital
| | | | - Phuong Thi Vu
- Department of Laboratory, Vinmec Times City International General Hospital
| | - Hyeon Gyu Yi
- Department of Oncology and Hematology
- College of Health Sciences, VinUniversity, Hanoi, Vietnam
| |
Collapse
|
4
|
Abrisqueta P, Nadeu F, Bosch-Schips J, Iacoboni G, Serna A, Cabirta A, Yáñez L, Quintanilla-Martínez L, Bosch F. From genetics to therapy: Unraveling the complexities of Richter transformation in chronic lymphocytic leukemia. Cancer Treat Rev 2023; 120:102619. [PMID: 37660626 DOI: 10.1016/j.ctrv.2023.102619] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
Richter transformation (RT) refers to the progression of chronic lymphocytic leukemia, the most prevalent leukemia among adults, into a highly aggressive lymphoproliferative disorder, primarily a diffuse large B-cell lymphoma. This is a severe complication that continues to be a therapeutic challenge and remains an unmet medical need. Over the last five years, significant advances have occurred in uncovering the biological processes leading to the RT, refining criteria for properly diagnose RT from other entities, and exploring new therapeutic options beyond the ineffective chemotherapy. This review summarizes current knowledge in RT, including recent advances in the understanding of the pathogenesis of RT, in the classification of RT, and in the development of novel therapeutic strategies for this grave complication.
Collapse
Affiliation(s)
- Pau Abrisqueta
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Ferran Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Jan Bosch-Schips
- Department of Pathology, Hospital Universitari de Bellvitge-Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Gloria Iacoboni
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Angel Serna
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Alba Cabirta
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Lucrecia Yáñez
- Department of Hematology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Leticia Quintanilla-Martínez
- Institute of Pathology and Neuropathology, Tübingen University Hospital and Comprehensive Cancer Center Tübingen-Stuttgart, 72076 Tübingen, Germany
| | - Francesc Bosch
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain.
| |
Collapse
|
5
|
Auerbach A, Aguilera NS. The changing landscape of pediatric histiocytoses: Birth, life, and transdifferentiation of pediatric histiocytes. Semin Diagn Pathol 2023; 40:420-428. [PMID: 37258365 DOI: 10.1053/j.semdp.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/19/2023] [Indexed: 06/02/2023]
Abstract
Histiocytic neoplasms in the children are very rare, and histiocytoses can occur in the perinatal period. The presumed origins and presentation of specific histiocytoses in the pediatric age group are described. Common and newly described histiocytoses are presented including Langerhans cell histiocytosis, Rosai-Dorfman disease, histiocytic sarcoma, ALK positive histiocytosis, and hemophagocytic lymphohistiocytosis. Molecular findings common to pediatric histiocytoses are also discussed.
Collapse
Affiliation(s)
- Aaron Auerbach
- Joint Pathology Center, Silver Spring, MD, United States of America
| | - Nadine S Aguilera
- University of Virginia Health System, Charlottesville, VA, United States of America.
| |
Collapse
|
6
|
Auerbach A, Girton M, Aguilera N. Controversies in the Spleen: Histiocytic, Dendritic, and Stromal Cell Lesions. Surg Pathol Clin 2023; 16:385-400. [PMID: 37149364 DOI: 10.1016/j.path.2023.01.004] [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: 05/08/2023]
Abstract
Histiocytic, dendritic, and stromal cell lesions that occur in the spleen are challenging diagnostically, not well studied due to their rarity, and therefore somewhat controversial. New techniques for obtaining tissue samples also create challenges as splenectomy is no longer common and needle biopsy does not afford the same opportunity for examination of tissue. Characteristic primary splenic histiocytic, dendritic, and stromal cell lesions are presented in this paper with new molecular genetic findings in some entities that help differentiate these lesions from those occurring in non-splenic sites, such as soft tissue, and identify possible molecular markers for diagnosis.
Collapse
Affiliation(s)
| | - Mark Girton
- University of Virginia Health System, Charlottesville, VA, USA
| | - Nadine Aguilera
- University of Virginia Health System, Charlottesville, VA, USA.
| |
Collapse
|
7
|
Zhao Y, Deng Y, Jiang Y, Zheng W, Tan Y, Yang Z, Wang Z, Xu F, Cheng Z, Yuan L, Peng H. Case report: Targeting the PD-1 receptor and genetic mutations validated in primary histiocytic sarcoma with hemophagocytic lymphohistiocytosis. Front Immunol 2023; 14:1127599. [PMID: 36969238 PMCID: PMC10030599 DOI: 10.3389/fimmu.2023.1127599] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/22/2023] [Indexed: 03/10/2023] Open
Abstract
Histiocytic sarcoma (HS) is a rare hematological malignancy with limited treatment options, and it is also prone to complications such as hemophagocytic lymphohistiocytosis (HLH) in the later stages of the disease, leading to difficulties in treatment and poor prognosis. It highlights the importance of developing novel therapeutic agents. Herein, we present a case of a 45-year-old male patient who was diagnosed with PD-L1-positive HS with HLH. The patient was admitted to our hospital with recurrent high fever, multiple skin rashes with pruritus throughout the body and enlarged lymph nodes. Subsequently, pathological biopsy of the lymph nodes revealed high expression of CD163, CD68, S100, Lys and CD34 in the tumor cells and no expression of CD1a and CD207, confirming this rare clinical diagnosis. Concerning the low remission rate by conventional treatment in this disease, the patient was administered with sintilimab (an anti-programmed cell death 1 [anti-PD-1] monoclonal antibody) at 200 mg/d combined with a first-line chemotherapy regimen for one cycle. Further exploration of pathological biopsy by using next-generation gene sequencing led to the use of targeted therapy of chidamide. After one cycle of combination therapy (chidamide+sintilimab, abbreviated as CS), the patient achieved a favorable response. The patient showed remarkable improvement in the general symptoms and laboratory examination results (e.g., elevated indicators of inflammation); even the clinical benefits was not persistent, he survived one more month after his cessation of treatment by himself due to economic difficulty. Our case suggests that PD-1 inhibitor coupled with targeted therapy might constitute a potential therapeutic option for primary HS with HLH.
Collapse
Affiliation(s)
- Yan Zhao
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yating Deng
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yi Jiang
- Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wenli Zheng
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanlin Tan
- Department of Imaging, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhiwu Yang
- Department of Hematology, Yiyang Central Hospital, Yiyang, Hunan, China
| | - Zhihua Wang
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Feng Xu
- Department of Thyroid and Breast Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhao Cheng
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lingli Yuan
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- *Correspondence: Lingli Yuan, ; Hongling Peng,
| | - Hongling Peng
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Engineering Research Center of Cell Immunotherapy for Hematopoietic Malignancies, Changsha, Hunan, China
- *Correspondence: Lingli Yuan, ; Hongling Peng,
| |
Collapse
|
8
|
Gauto-Mariotti E, Nguyen AJ, Waters C, Scurti GM, Haddad S, Velankar MM, Dalheim AV, Dronzek V, Ketterling RP, Nishimura MI, Dalland JC, Hossain NM. Transdifferentiation of high-grade B-cell lymphoma with MYC and BCL2 rearrangements into histiocytic sarcoma after CAR T-cell therapy: a case report. J Hematop 2022. [DOI: 10.1007/s12308-022-00519-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
|
9
|
Bahrami E, Najafi M, Jahanbakhshi A, Hatam J, Molanaei S, Ciammella P, Cozzi S. Histiocytic Sarcoma Involving Cervical Vertebra: A Case Report and Review of the Literature. Brain Sci 2022; 12:brainsci12070958. [PMID: 35884764 PMCID: PMC9321643 DOI: 10.3390/brainsci12070958] [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: 05/06/2022] [Revised: 06/08/2022] [Accepted: 06/23/2022] [Indexed: 12/10/2022] Open
Abstract
Histiocytic sarcoma (HS) is a rare neoplasm composed of cells with immunohistochemical characteristics of mature histiocytes. It can be disseminated or localized and usually involves the skin, spleen, and gastrointestinal tract. Primary involvement of the vertebral column is extremely rare. We report a 29-year-old female who presented with neck pain and had a destructive 35*43*48 mm lesion in C2 with a paravertebral extension. The initial biopsy did not lead to the correct diagnosis. She later developed dysphagia, and the anterior approach was used for tumor decompression. The diagnosis of cervical histiocytic sarcoma was made, and she underwent radiotherapy. The follow-up MRI showed a marked response to radiotherapy. Here, we report the first case of cervical HS, review all cases of vertebral HS, compare patients’ characteristics and clinical courses, and discuss diagnostic nuances and treatment options.
Collapse
Affiliation(s)
- Eshagh Bahrami
- Skull Base Research Center, Department of Neurosurgery, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran 1997667665, Iran; (E.B.); (M.N.); (J.H.)
| | - Masoumeh Najafi
- Skull Base Research Center, Department of Neurosurgery, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran 1997667665, Iran; (E.B.); (M.N.); (J.H.)
| | - Amin Jahanbakhshi
- Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran 1997667665, Iran
- Correspondence:
| | - Jaber Hatam
- Skull Base Research Center, Department of Neurosurgery, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran 1997667665, Iran; (E.B.); (M.N.); (J.H.)
| | - Saadat Molanaei
- Department of Pathology, Milad Hospital, Hakim Highway, Tehran 1997667665, Iran;
| | - Patrizia Ciammella
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (P.C.); (S.C.)
| | - Salvatore Cozzi
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (P.C.); (S.C.)
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Furui Y, Kurata T, Komori K, Uchida E, Miyairi Y, Chiba A, Ogiso Y, Sakashita K. A case of recurrent refractory cervical primary histiocytic sarcoma treated with pembrolizumab. Int Cancer Conf J 2022; 11:280-285. [DOI: 10.1007/s13691-022-00562-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022] Open
|
12
|
Shahrokh S, Rakhsha A, Shahin M, Javadzadegan A, Ahadi M, Azghandi S, Taghizadeh-Hesary F. Successful Treatment of Central Nervous System Histiocytic Sarcoma With Craniectomy and Adjuvant Radiotherapy. Cureus 2022; 14:e24690. [PMID: 35663678 PMCID: PMC9162887 DOI: 10.7759/cureus.24690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 11/05/2022] Open
|
13
|
Lenz JA, Assenmacher CA, Costa V, Louka K, Rau S, Keuler NS, Zhang PJ, Maki RG, Durham AC, Radaelli E, Atherton MJ. Increased tumor-infiltrating lymphocyte density is associated with favorable outcomes in a comparative study of canine histiocytic sarcoma. Cancer Immunol Immunother 2022; 71:807-818. [PMID: 34415404 PMCID: PMC8858331 DOI: 10.1007/s00262-021-03033-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 08/12/2021] [Indexed: 12/18/2022]
Abstract
Histiocytic sarcoma (HS) is a rare and aggressive tumor in humans with no universally agreed standard of care therapy. Spontaneous canine HS exhibits increased prevalence in specific breeds, shares key genetic and biologic similarities with the human disease, and occurs in an immunocompetent setting. Previous data allude to the immunogenicity of this disease in both species, highlighting the potential for their successful treatment with immunotherapy. Quantification of CD3 tumor-infiltrating lymphocytes (TIL) in five cases of human HS revealed variable intra-tumoral T cell infiltration. Due to the paucity of human cases and lack of current model systems in which to appraise associations between anti-tumor immunity and treatment-outcome in HS, we analyzed clinical data and quantified TIL in 18 dogs that were previously diagnosed with localized HS and treated with curative-intent tumor resection with or without adjuvant chemotherapy. As in humans, assessment of TIL in biopsy tissues taken at diagnosis reveal a spectrum of immunologically "cold" to "hot" tumors. Importantly, we show that increased CD3 and granzyme B TIL are positively associated with favorable outcomes in dogs following surgical resection. NanoString transcriptional analyses revealed increased T cell and antigen presentation transcripts associated with prolonged survival in canine pulmonary HS and a decreased tumor immunogenicity profile associated with shorter survivals in splenic HS. Based on these findings, we propose that spontaneous canine HS is an accessible and powerful novel model to study tumor immunology and will provide a unique platform to preclinically appraise the efficacy and tolerability of anti-cancer immunotherapies for HS.
Collapse
Affiliation(s)
- Jennifer A Lenz
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Charles-Antoine Assenmacher
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Victoria Costa
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Katie Louka
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Suzanne Rau
- Metropolitan Veterinary Associates, Norristown, PA, USA
| | - Nicholas S Keuler
- Department of Statistics, University of Wisconsin-Madison, Madison, WI, USA
| | - Paul J Zhang
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert G Maki
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amy C Durham
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Enrico Radaelli
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Matthew J Atherton
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| |
Collapse
|
14
|
Rare Presentation of Rosai-Dorfman Disease in Soft Tissue: Diagnostic Findings and Surgical Treatment. Case Rep Surg 2022; 2022:8440836. [PMID: 35402057 PMCID: PMC8986417 DOI: 10.1155/2022/8440836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction and Importance. Rosai-Dorfman disease (RDD) is a rare, benign type II histiocytosis characterized by the infiltration of S100+ histiocytes and emperipolesis. The disease may present in the lymph nodes (nodal RDD), in extranodal sites, or in both nodal and extranodal sites. Among those patients who present exclusively in extranodal sites, only a minority of cases present in the soft tissue. Case Presentation. An 18-year-old female presented to orthopedic oncology clinic with a chief complaint of a mass located in her lower back. The patient underwent excision of the lumbosacral mass. Pathologic review demonstrated emperipolesis of lymphocytes and plasma cells within enlarged, eosinophilic histiocytes in a background of lymphoplasmacytic infiltration and collagenous stroma. Immunohistochemical staining demonstrated S100+ and CD163+ histiocytes, consistent with diagnosis of soft tissue RDD. Clinical Discussion. Histologically, RDD is generally characterized by emperipolesis—the presence of intact lymphocytes within the histiocyte cytoplasm—and a mixed infiltrate of S100+ histiocytes, mononuclear cells, plasma cells, and lymphocytes. Although soft tissue RDD may histologically resemble nodal RDD, soft tissue RDD also demonstrates some notable histologic differences including the lack of nodal architecture, the presence of increased fibrosis and collagen deposition, and generally fewer RDD cells. Conclusion. This case presentation demonstrates one few reports of isolated soft tissue RDD within the lumbosacral region without associated lymphadenopathy or skin changes and highlights the heterogeneity that still exists in the treatment paradigm of extranodal RDD.
Collapse
|
15
|
Cassidy DP, Rosenberg AE, Poveda J, Velez-Torres J, Chapman J. Nonlymphoid Hematopoietic Diseases Presenting in Bone, Soft Tissue, and Other Extranodal Sites. Arch Pathol Lab Med 2021; 146:1144-1159. [DOI: 10.5858/arpa.2021-0229-ra] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 11/06/2022]
Abstract
Context.—
Although rare in everyday practice, the initial presentation of hematopoietic neoplasms other than lymphoma in the musculoskeletal system and other extranodal sites can generate challenging diagnostic problems for surgical pathologists.
Objective.—
To review the morphologic and immunophenotypic features of various nonlymphoid hematopoietic diseases presenting at extranodal sites, with emphasis on the inherent diagnostic pitfalls and differential diagnoses of these entities to aid surgical pathologists in their accurate recognition.
Data Sources.—
Cases reviewed herein represent both in-house and consult cases seen at our institution between 2010 and 2021.
Conclusions.—
Entities that present in this way include myeloid neoplasms and histiocytic/dendritic cell neoplasms. These tumors commonly cause nonspecific symptoms, and their histologic appearance can overlap with a variety of benign neoplasms and reactive processes. This can lead to delay in diagnosis and intervention with potentially lifesaving therapy; thus, accurate and expedient recognition is of paramount importance.
Collapse
Affiliation(s)
- Daniel P. Cassidy
- From the Division of Hematopathology (Cassidy, Poveda, Chapman), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Division of Bone and Soft Tissue Pathology (Cassidy, Rosenberg, Velez-Torres), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Andrew E. Rosenberg
- Division of Bone and Soft Tissue Pathology (Cassidy, Rosenberg, Velez-Torres), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Julio Poveda
- From the Division of Hematopathology (Cassidy, Poveda, Chapman), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Jaylou Velez-Torres
- Division of Bone and Soft Tissue Pathology (Cassidy, Rosenberg, Velez-Torres), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Jennifer Chapman
- From the Division of Hematopathology (Cassidy, Poveda, Chapman), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| |
Collapse
|
16
|
Gao J, Fu L, Lu X, Sukhanova M, Frankfurt O, Mohtashamian A, Chadburn A, Jennings L, Aqil B, Chen Q, Chen YH. Mast cell sarcoma transdifferentiated from clonally-related T-lymphoblastic leukemia upon acquisition of TP53 mutation and genetic complexity. Leuk Lymphoma 2021; 62:3304-3307. [PMID: 34261406 DOI: 10.1080/10428194.2021.1950710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Juehua Gao
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lucy Fu
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Xinyan Lu
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Madina Sukhanova
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Olga Frankfurt
- Hematology and Oncology, Hematology Oncology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Amy Chadburn
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Lawrence Jennings
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Barina Aqil
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Qing Chen
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Yi-Hua Chen
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
17
|
Afzal A, Asadbeigi SN, Farooque U, Mather C, Khan S. Histiocytic sarcoma arising from a lymph node: a diagnostic conundrum. Int Cancer Conf J 2021; 10:244-247. [PMID: 34221840 DOI: 10.1007/s13691-021-00489-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 05/05/2021] [Indexed: 11/30/2022] Open
Abstract
Histiocytic Sarcoma (HS) is extremely rare, with only a few hundred cases reported in the literature. The majority of patients present with symptoms due to unifocal or multifocal extra-nodal disease. Less than 20% of these cases show solitary involvement of a lymph node. We report a case of a solitary HS in a 53-year-old woman presenting with a 2.7-cm right groin mass arising from an inguinal lymph node. The initial cytologic examination of the tissue showed a high-grade spindle-shaped morphology with high-grade mitotic activity. A high-grade sarcoma was initially considered considering the absence of normal lymphoid aggregate and the presence of high-grade cytologic features in the cells. To evaluate the tumor in its entirety, the mass was surgically excised. A histological examination of the tumor showed focal rimming of the lymphoid tissue at the periphery and a centrally located stellate necrotic focus. The tumor cells had an epithelioid to spindle cell morphology along with large uniform nuclei and prominent nucleoli. A high mitotic index was present. Immunohistochemistry (IHC) stains showed strong positivity for CD68, CD163, and Vimentin, and were weakly positive for SMA and CD45. Based on the histologic and clinical examination, a diagnosis of HS was made. Multiple malignancies can mimic HS histopathology and the rarity of this tumor makes the diagnosis more challenging. No fine-needle aspiration (FNA) criteria for its diagnosis have been recognized. Herein, we report a rare case of an isolated HS involving a lymph node which resembled high-grade sarcoma on the FNA biopsy to raise awareness among our surgical pathologist colleagues.
Collapse
Affiliation(s)
- Anoshia Afzal
- Department of Pathology, The University of Oklahoma Health Science Center, Oklahoma City, OK USA
| | - Sepideh N Asadbeigi
- Department of Dermatopathology, McGaw Medical Center of Northwestern University, Suite 1600, 676 North Saint Clair Street, Chicago, IL 60611 USA
| | - Umar Farooque
- Department of Neurology, Dow University of Health Sciences, Karachi, Pakistan
| | - Christy Mather
- Department of Psychology, University of Tulsa, Tulsa, OK USA
| | - Shahbaz Khan
- Department of Pathology, Indiana University School of Medicine, Indianapolis, IN USA
| |
Collapse
|
18
|
Evans JM, Parker HG, Rutteman GR, Plassais J, Grinwis GCM, Harris AC, Lana SE, Ostrander EA. Multi-omics approach identifies germline regulatory variants associated with hematopoietic malignancies in retriever dog breeds. PLoS Genet 2021; 17:e1009543. [PMID: 33983928 PMCID: PMC8118335 DOI: 10.1371/journal.pgen.1009543] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/12/2021] [Indexed: 12/18/2022] Open
Abstract
Histiocytic sarcoma is an aggressive hematopoietic malignancy of mature tissue histiocytes with a poorly understood etiology in humans. A histologically and clinically similar counterpart affects flat-coated retrievers (FCRs) at unusually high frequency, with 20% developing the lethal disease. The similar clinical presentation combined with the closed population structure of dogs, leading to high genetic homogeneity, makes dogs an excellent model for genetic studies of cancer susceptibility. To determine the genetic risk factors underlying histiocytic sarcoma in FCRs, we conducted multiple genome-wide association studies (GWASs), identifying two loci that confer significant risk on canine chromosomes (CFA) 5 (Pwald = 4.83x10-9) and 19 (Pwald = 2.25x10-7). We subsequently undertook a multi-omics approach that has been largely unexplored in the canine model to interrogate these regions, generating whole genome, transcriptome, and chromatin immunoprecipitation sequencing. These data highlight the PI3K pathway gene PIK3R6 on CFA5, and proximal candidate regulatory variants that are strongly associated with histiocytic sarcoma and predicted to impact transcription factor binding. The CFA5 association colocalizes with susceptibility loci for two hematopoietic malignancies, hemangiosarcoma and B-cell lymphoma, in the closely related golden retriever breed, revealing the risk contribution this single locus makes to multiple hematological cancers. By comparison, the CFA19 locus is unique to the FCR and harbors risk alleles associated with upregulation of TNFAIP6, which itself affects cell migration and metastasis. Together, these loci explain ~35% of disease risk, an exceptionally high value that demonstrates the advantages of domestic dogs for complex trait mapping and genetic studies of cancer susceptibility. We have identified two regions of the canine genome that explain a striking 35% of risk for developing histiocytic sarcoma in FCRs. The disease is uniformly lethal, affects 20% of FCRs, and parallels a cancer of the same name in humans. Both regions harbor genes involved in cell migration and cancer-related pathways. The first includes variants in regulatory regions at the tumor suppressor PIK3R6 locus that are strongly associated with histiocytic sarcoma and likely confer risk for other hematopoietic cancers. FCRs with risk alleles at the second locus demonstrate increased expression of TNFAIP6, which correlates with poor prognosis in multiple human cancers. In identifying genomic differences between affected and unaffected dogs, we advance our understanding of both canine and human health biology and set the stage for the development of diagnostic and therapeutic strategies.
Collapse
Affiliation(s)
- Jacquelyn M. Evans
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Heidi G. Parker
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Gerard R. Rutteman
- Department of Clinical Sciences, division Internal Medicine of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Jocelyn Plassais
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Guy C. M. Grinwis
- Department Biomedical Health Sciences, division Pathology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Alexander C. Harris
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Susan E. Lana
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
| | - Elaine A. Ostrander
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
- * E-mail:
| |
Collapse
|
19
|
CLL dedifferentiation to clonally related myeloid cells. Blood Adv 2021; 4:6169-6174. [PMID: 33351112 DOI: 10.1182/bloodadvances.2020002726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/14/2020] [Indexed: 02/07/2023] Open
Abstract
Key Points
Common progenitor cells exist in clonally related concomitant chronic lymphocytic leukemia and acute myeloid leukemias. CLL cells dedifferentiated to clonally related myeloid cells posttransplantation.
Collapse
|
20
|
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.
Collapse
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
| |
Collapse
|
21
|
Auerbach A, Schmieg JJ, Aguilera NS. Pediatric Lymphoid and Histiocytic Lesions in the Head and Neck. Head Neck Pathol 2021; 15:41-58. [PMID: 33723759 PMCID: PMC7959275 DOI: 10.1007/s12105-020-01257-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/19/2020] [Indexed: 12/31/2022]
Abstract
Lymphoid and histiocytic lesions of the head and neck in pediatric patients is a fascinating topic as most of these lesions are benign, but that the neoplastic cases are essential to diagnose accurately for appropriate treatment. It is thought that 90% of children will have palpable lymph nodes between the ages of 4 to 8; most, but not all, are non-malignant and some resolve spontaneously without treatment. This paper will look at many of the benign and malignant lesions of both lymphocytic and histiocytic origin that present in the head and neck of children focusing on their diagnostic criteria. There is a very pertinent discussion of nonmalignant lymphoid proliferations, as infections and other reactive conditions dominate the pathology of pediatric lymphohistiocytic head and neck lesions. Discussion of those lymphomas which arise more frequently in the head and neck focuses on those seen in children and young adults such as classic Hodgkin lymphoma and Burkitt lymphoma, as well as new more controversial entities such as pediatric-type follicular lymphoma. Histiocytic lesions, both benign and malignant, are described and may be challenging to diagnose.
Collapse
Affiliation(s)
- A Auerbach
- The Joint Pathology Center, Silver Spring, MD, USA.
| | - J J Schmieg
- The Joint Pathology Center, Silver Spring, MD, USA
| | - N S Aguilera
- University of Virginia Health System, Charlottesville, VA, USA
| |
Collapse
|
22
|
d'Amore ESG, Mainardi C, Mussolin L, Carraro E, Alaggio R, Lazzari E, Fusetti S, Ghirotto C, Marzollo A, Biddeci G, Toffolutti T, Massano D, Scarzello G, Zuliani M, Putti MC, Biffi A, Pillon M. Histiocytic sarcoma arising in a child affected by Burkitt lymphoma, with t(8;14)(q24;q32) positivity in both tumors. Pediatr Hematol Oncol 2021; 38:1-7. [PMID: 33621154 DOI: 10.1080/08880018.2020.1871452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Chiara Mainardi
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| | - Lara Mussolin
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy.,Institute of Pediatric Research, Fondazione Città della Speranza, Padova, Italy
| | - Elisa Carraro
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| | - Rita Alaggio
- Department of Pathology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Elena Lazzari
- Department of Pathology, San Bortolo Hospital, Vicenza, Italy
| | - Stefano Fusetti
- Maxillofacial Surgery Unit, Department of Neurosciences, University of Padova Medical School, Padova, Italy
| | - Cristina Ghirotto
- Maxillofacial Surgery Unit, ULSS 3 Serenissima Hospital, Venezia, Italy
| | - Antonio Marzollo
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| | - Giada Biddeci
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| | - Tiziana Toffolutti
- Department of Medicine, Pediatric Radiology Unit Radiology Institute Hospital-University of Padova, Padova, Italy
| | - Davide Massano
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| | - Giovanni Scarzello
- Radiotherapy Department, Istituto Oncologico Veneto-IRCCS, Padova, Italy
| | - Monica Zuliani
- Department of Medicine, Pediatric Radiology Unit Radiology Institute Hospital-University of Padova, Padova, Italy
| | - Maria Caterina Putti
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| | - Alessandra Biffi
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy.,Institute of Pediatric Research, Fondazione Città della Speranza, Padova, Italy.,Gene Therapy Program, Dana Farber/Boston Children's Cancer and Blood Disorders Centers, Boston, Massachusetts, USA
| | - Marta Pillon
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| |
Collapse
|
23
|
Nicola M, Onorati M, Lancia M, Varca V, Di Nuovo F. Original Observation of Primary Bladder Histiocytic Sarcoma: First Case Report. Cureus 2021; 13:e12771. [PMID: 33614360 PMCID: PMC7888511 DOI: 10.7759/cureus.12771] [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] [Indexed: 11/05/2022] Open
Abstract
Histiocytic sarcoma (HS) is a rare malignant lymphohematopoietic neoplasm; it has been cited in the recent World Health Organization (WHO) classification as a malignant proliferation of cells exhibiting morphological and immunophenotypic features of mature histiocytes. To our knowledge, the present case is the first to be described in the bladder of a patient without a history of lymphoma. Only one case has been reported so far regarding a secondary bladder presentation in the setting of a previous diffuse large B-cell lymphoma. We discuss the case of a 68-year-old male who presented with hematuria and dysuria. CT scan revealed a 4-cm intravesical mass that histological examination defined as HS. Our objective was to describe the clinical, histological, immunophenotypical, molecular characteristics and discuss the differential diagnoses of this first case of primary bladder HS. Our research was based on a review of selected articles obtained via the PubMed database. This extremely rare experience provided us with the opportunity to depict an interesting case, highlight its uniqueness, and build up new pathological evidence.
Collapse
Affiliation(s)
- Marta Nicola
- Pathology, ASST Rhodense, Garbagnate Milanese, ITA
| | | | - Mauro Lancia
- Pathology, ASST Rhodense, Garbagnate Milanese, ITA
| | | | - Franca Di Nuovo
- Pathology, ASST Rhodense, Garbagnate Milanese, ITA.,Pathology, G. Salvini Hospital, Garbagnate Milanese, ITA
| |
Collapse
|
24
|
Ohe R, Kabasawa T, Utsunomiya A, Urano Y, Kitaoka T, Suzuki K, Aung NY, Kawamura I, Tajima K, Ishiyama T, Yamakawa M. Nodal histiocytic sarcoma with prominent eosinophilic infiltration: expression of eotaxin-2 on tumor cells. Diagn Pathol 2021; 16:6. [PMID: 33436014 PMCID: PMC7805230 DOI: 10.1186/s13000-020-01061-4] [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: 10/09/2020] [Accepted: 12/21/2020] [Indexed: 11/16/2022] Open
Abstract
Background Histiocytic sarcoma (HS) is a rare neoplasm showing morphological and immunophenotypic features of mature tissue histiocytes. We report a patient with nodal HS exhibiting prominent reactive eosinophilic infiltration. Case presentation A 68-year-old man presented with intermittent left lower abdominal pain and weight loss over 3 months. A computed tomography scan revealed multiple abdominal nodules. Open biopsy of the mesenteric tumors was performed for definitive diagnosis. Histologically, the tumor was comprised of a diffuse noncohesive proliferation of pleomorphic large cells, including multinucleated cells. Neoplastic cells were positive for histiocytic markers (CD68, CD163, and LIGHT) and PD-L1 but lacked markers of Langerhans cells, follicular dendritic cells, and epithelial cells. Frequent reactive inflammatory cells were intermingled in the background. Interestingly, prominent eosinophilic infiltration was also noted. Spindle neoplastic cells were prone to be present around areas with little to no eosinophilic infiltration and exhibiting fibrosis and lymphatic vessel proliferation. Conversely, polygonal neoplastic cells were prone to be present around areas with relatively large amounts of eosinophilic infiltration without fibrosis or lymphatic vessel proliferation. Immunohistochemically, the tumor cells and reactive eosinophils expressed eotaxin-2 and eotaxin-3, respectively. Conclusion We revealed that eotaxins induced the selective migration of eosinophils into tissues in this case. These eosinophils may affect the tumor remodeling and tumor biology characteristics of HS, such as fibrosis and lymphatic vessel proliferation. Supplementary Information The online version contains supplementary material available at 10.1186/s13000-020-01061-4.
Collapse
Affiliation(s)
- Rintaro Ohe
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
| | - Takanobu Kabasawa
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Aya Utsunomiya
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Yuka Urano
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Takumi Kitaoka
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Kazushi Suzuki
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Naing Ye Aung
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Ichiro Kawamura
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Katsushi Tajima
- Department of Hematology, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Tomoharu Ishiyama
- Division of Surgery, Yamagata Prefectural Shinjo Hospital, Shinjo, Japan
| | - Mitsunori Yamakawa
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| |
Collapse
|
25
|
Abstract
Cutaneous histiocytic sarcoma (HS) is a rare malignant tumor. An 82-year-old woman presented with a 4 × 2-cm irregular-shaped red nodule on the left posterior scalp. A biopsy specimen revealed sheets of pleomorphic atypical cells in the dermis and subcutis. A diagnosis of HS was made based on the results of a panel of immunohistochemical stains that revealed positivity of leukocyte common antigen, CD4, CD163, and HLA-DR. At the time of resection, the tumor grew rapidly to 12 × 6.5 × 5 cm in size in 2 months. The resected tumor comprised round, oval, plasmacytoid, and spindled cells. Signet-ring cell type tumor cells were also observed. The histiocytic nature of HS was confirmed owing to the presence of cellular cannibalism, emperipolesis, Langhans giant cell-like cells, Touton giant cell-like cells, foreign-body giant cell-like cells, and hemosiderin laden cells. In some foci, a storiform pattern and fascicular pattern were occasionally observed. Local recurrence occurred shortly after resection. Subsequent radiation therapy showed insufficient effectiveness. It is challenging to make a diagnosis of HS without performing immunohistochemical studies; however, a variety of histiocytic features confirmed in hematoxylin and eosin-stained sections may suggest HS.
Collapse
|
26
|
Krishnamurthy K, Delgado R, Kochiyil J, Medina AM. Primary Histiocytic Sarcoma in Adult Polycystic Kidney Disease: Case Report and Review of Literature. Int J Surg Pathol 2020; 29:321-326. [PMID: 32677548 DOI: 10.1177/1066896920942891] [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: 11/16/2022]
Abstract
Genetically driven tissue destruction followed by remodeling in adult polycystic kidney disease (APKD) raises the possibility of malignant transformation. Renal cell carcinoma (RCC) associated with APKD has been frequently reported in the literature; however, only a few cases of nonepithelial neoplasms arising in APKD have been described so far. Histiocytic sarcoma (HS) is a lymphohematopoietic malignant neoplasm that accounts for less than 1% of hematologic malignancies. In this article, we describe a case of primary HS occurring in a 61-year-old man with end-stage renal disease secondary to APKD. This is the first reported case of primary HS in the setting of APKD. The aberrant h-caldesmon expression seen in this case is another novel finding that has previously not been described. This case highlights the importance of morphology in guiding diagnostic workup and reiterates the necessity of maintaining a high index of suspicion for neoplastic entities in APKD.
Collapse
Affiliation(s)
| | - Ruben Delgado
- 5258Mount Sinai Medical Center, Miami Beach, FL, USA
| | | | - Ana Maria Medina
- 5258Mount Sinai Medical Center, Miami Beach, FL, USA.,158263Florida International University, Miami, FL, USA
| |
Collapse
|
27
|
Zanelli M, Ricci S, Zizzo M, Sanguedolce F, Martino G, Fraternali Orcioni G, Ascani S. Bone marrow coexistence of chronic lymphocytic leukemia and Langerhans cell sarcoma. Ann Hematol 2020; 99:2957-2959. [PMID: 32621179 DOI: 10.1007/s00277-020-04167-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/29/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Stefano Ricci
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Sanguedolce
- Pathology Unit, Azienda Ospedaliero-Universitaria - Ospedali Riuniti di Foggia, Foggia, Italy
| | - Giovanni Martino
- Hematology Unit, CREO, Azienda Ospedaliera di Perugia, University of Perugia, Perugia, Italy
| | | | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, Terni, Italy
| |
Collapse
|
28
|
Benign Histiocyte-Rich Pseudotumor Developing Postchemotherapy and Mimicking Residual Disease. Case Rep Pathol 2020; 2020:4674103. [PMID: 32695545 PMCID: PMC7352137 DOI: 10.1155/2020/4674103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/19/2020] [Indexed: 11/17/2022] Open
Abstract
Histiocyte-rich pseudotumors (HRPT) developing postchemoradiation therapy are a florid response to treatment and reparative change. Although these are benign processes, clinically and radiologically, these may mimic recurrent/relapsed disease. We describe a case of an adult male with history of diffuse large B-cell lymphoma (DLBCL), status postchemoradiation therapy, who developed HRPT at the site of original involvement, mimicking relapse of disease on positron emission tomography/computed tomography (PET/CT) imaging. This is one of the few reported cases of posttreatment HRPT. This entity is important to point out the limitations of PET/CT imaging in patients with lymphomas and metastatic disease and stresses the importance of an excisional biopsy for determining relapse and the need for further treatment.
Collapse
|
29
|
Tibaldi E, Gnudi F, Panzacchi S, Mandrioli D, Vornoli A, Manservigi M, Sgargi D, Falcioni L, Bua L, Belpoggi F. Identification of aspartame-induced haematopoietic and lymphoid tumours in rats after lifetime treatment. Acta Histochem 2020; 122:151548. [PMID: 32622430 DOI: 10.1016/j.acthis.2020.151548] [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: 01/15/2020] [Revised: 03/02/2020] [Accepted: 03/20/2020] [Indexed: 12/22/2022]
Abstract
Lymphomas and leukaemias involving the lung have in some cases been hard to distinguish from respiratory tract infection in Sprague-Dawley (SD) rats from long-term bioassays. In order to differentiate between tumours and immune cell infiltrates, updated pathological criteria and nomenclature were used and immunohistochemistry (IHC) was applied to haematopoietic and lymphoid tissue tumours (HLTs) in the original prenatal long-term Aspartame (APM) study performed by the Ramazzini Institute (RI). All 78 cases of HLTs from treated and control groups were re-examined based on light microscopic morphological characteristics and subjected to a panel of IHC markers including Ki67, CD3, PAX5, CD20, CD68, TdT, CD45, CD14 and CD33. The analysis confirmed the diagnoses of HLTs in 72 cases, identified 3 cases of preneoplastic lesions (lymphoid hyperplasia), and categorized 3 cases as inflammatory lesions. A statistically significant increase in total HLTs (p = 0.006), total lymphomas (p = 0.032) and total leukaemias (p = 0.031) in treated female rats was confirmed (high dose vs control), and a statistically significant linear trend for each HLT type was also observed. After the HLT cases re-evaluation, the results obtained are consistent with those reported in the previous RI publication and reinforce the hypothesis that APM has a leukaemogenic and lymphomatogenic effect.
Collapse
|
30
|
Shangpliang D, Baishya P, Raphael V, Dey B, Jagtap VK. Pediatric multifocal histiocytic sarcoma- a fatal diagnosis not to miss! AUTOPSY AND CASE REPORTS 2020; 10:e2020170. [PMID: 33344287 PMCID: PMC7703460 DOI: 10.4322/acr.2020.170] [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] [Indexed: 11/23/2022] Open
Abstract
Histiocytic sarcoma (HS) is a rare hematolymphoid malignant neoplasm with an aggressive clinical course. It can arise de novo or from low-grade B-cell lymphoma. We describe the case of a 16-year-old boy referred to our hospital with generalized lymphadenopathy, weight loss, and decreased appetite for one month. The patient died undiagnosed on the 7th day of hospitalization. Lymph node and bone marrow biopsies were performed one day before the patient died. The lymph node biopsy revealed an architectural effacement with a diffuse proliferation of large pleomorphic neoplastic cells containing large, multilobulated nuclei, coarse vesicular chromatin, prominent nucleoli, and a moderate amount of eosinophilic cytoplasm. The bone marrow aspiration smears and biopsy also showed evidence of infiltration by these above-mentioned cells. Based on the morphology, along with the exclusion of many differential diagnoses by an extensive panel of immunohistochemical markers, a diagnosis of HS was made. This case report aims at evaluating all the clinical and immunophenotypic features of a case of HS with multifocal presentation and an aggressive clinical course in order to give a correct and definite diagnosis at the proper time.
Collapse
Affiliation(s)
- Darilin Shangpliang
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
| | - Pakesh Baishya
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
| | - Vandana Raphael
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
| | - Biswajit Dey
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
| | - Vikas Kantilal Jagtap
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Department of Radiotherapy and Oncology. Shillong, India
| |
Collapse
|
31
|
Reddivari AKR, Mehta P, Janapala US. Rare Presentation of a Rare Tumor: Histiocytic Sarcoma. Cureus 2020; 12:e7770. [PMID: 32461846 PMCID: PMC7243663 DOI: 10.7759/cureus.7770] [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] [Indexed: 11/21/2022] Open
Abstract
An 84-year-old male, with a large gouty tophus over the left elbow for 20 years, developed a new left elbow area mass about three months ago and presented to the emergency department (ED) with complaints of bleeding from that left elbow area mass after a small blunt injury. Initially diagnosed as olecranon bursitis, it had the worsening size and atypical growth associated with persistent leukocytosis. After being evaluated by multiple specialties, including infectious diseases, orthopedic surgery, and rheumatology, it was decided to do a biopsy, which resulted in the diagnosis of histiocytic sarcoma.
Collapse
Affiliation(s)
| | - Parth Mehta
- Internal Medicine, University of Illinois College of Medicine, Peoria, USA.,Internal Medicine, Unity Point Health Methodist Hospital, Peoria, USA
| | | |
Collapse
|
32
|
Lee KJ, Jeon JY, Lee SL, Oh ST, Seo KJ. Imprint cytology of histiocytic sarcoma manifesting as a retroperitoneal mass: A valuable aid for frozen section diagnosis. Diagn Cytopathol 2020; 48:571-575. [PMID: 32170826 DOI: 10.1002/dc.24411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 03/04/2020] [Indexed: 11/06/2022]
Abstract
Histiocytic sarcoma (HS) is a comparatively rare hematolymphoid neoplasm. Differential diagnosis of this entity has generally been proven to be so difficult that extensive immunohistochemical staining is required to confirm its presence. We herein present a case of HS manifesting as a retroperitoneal mass in which imprint cytology (IC) contributed to the diagnosis. A 77-year-old man was referred for the evaluation of a colonic tubulovillous polypoid lesion. Preoperative imaging revealed a 3 cm-sized polypoid lesion in the transverse colon. Incidentally, a retroperitoneal mass of 8 cm in the left para-aortic region was also detected. Diff-Quik stained IC slides were prepared as an adjunct to intraoperative pathology consultation. The smear exhibited moderate cellularity involving loosely cohesive cell clusters with intervening delicate vasculature. Most of the tumor cells consisted of large single cells with abundant eosinophilic cytoplasm that was vacuolated and foamy. The nuclei were predominantly large and eccentrically located. Mitotic figures were minimal in number and finely granular brown pigments were occasionally observed. A frozen section diagnosis was reported as a malignant neoplasm, and a histologic diagnosis of HS was confirmed by conducting a battery of immunohistochemical stains: negative for pan-cytokeratin, EMA, CD117, HMB45, Melan A, CD30, PAX5, CD20, S-100, and CD23 but strong positive for vimentin and CD68. This entity is rarely described in terms of cytopathologic features. This case study highlights how cytopathologists should be aware of HS as a retroperitoneal lesion and should become familiar with cytomorphologic features.
Collapse
Affiliation(s)
- Kyung Ji Lee
- Department of Pathology, Seoul Medical Science Institute, Seoul Clinical Laboratories, Seoul, Republic of Korea
| | - Jin Young Jeon
- Department of Hospital Pathology, Uijeongbu St. Mary's Hospital, Seoul, The Catholic University of Korea, Uijeongbu, Republic of Korea
| | - Su Lim Lee
- Department of Radiology, Uijeongbu St. Mary's Hospital, Seoul, The Catholic University of Korea, Uijeongbu, Republic of Korea
| | - Seong Taek Oh
- Department of Surgery, Uijeongbu St. Mary's Hospital, Seoul, The Catholic University of Korea, Uijeongbu, Republic of Korea
| | - Kyung Jin Seo
- Department of Hospital Pathology, Uijeongbu St. Mary's Hospital, Seoul, The Catholic University of Korea, Uijeongbu, Republic of Korea
| |
Collapse
|
33
|
Bang S, Kim Y, Chung MS, Park JS, Choi YY, Shin SJ. Primary Histiocytic Sarcoma Presenting as a Breast Mass: A Case Report. J Breast Cancer 2019; 22:491-496. [PMID: 31598348 PMCID: PMC6769387 DOI: 10.4048/jbc.2019.22.e32] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/22/2019] [Indexed: 11/30/2022] Open
Abstract
Histiocytic sarcoma is a rare hematologic malignancy, with very few cases of primary histiocytic sarcoma of the breast described in English scientific literature. Herein, we describe a case of primary histiocytic sarcoma of the breast in a 75-year-old woman, with no clinical history of malignant tumors, who presented with a palpable solitary breast mass. Microscopically, the resected breast mass showed large pleomorphic cells, some multinucleated giant cells, and admixed inflammatory components. The pleomorphic tumor cells further showed a diffuse, noncohesive growth pattern, an abundant eosinophilic cytoplasm, and strong and diffuse immunoreactivity for cluster of differentiation (CD) 68 and CD163. Furthermore, a whole-body positron-emission tomography/computed tomography using deoxy-2-[18F]fluoro-D-glucose performed after surgery showed no other masses or lesions. After surgical excision, the patient was followed up, and no evidence of tumor recurrence or metastasis was noted.
Collapse
Affiliation(s)
- Seongsik Bang
- Department of Pathology, College of Medicine, Hanyang University, Seoul, Korea
| | - Yeseul Kim
- Department of Pathology, College of Medicine, Hanyang University, Seoul, Korea
| | - Min Sung Chung
- Department of Surgery, College of Medicine, Hanyang University, Seoul, Korea
| | - Jeong Seon Park
- Department of Radiology, College of Medicine, Hanyang University, Seoul, Korea
| | - Yun Young Choi
- Department of Nuclear Medicine, College of Medicine, Hanyang University, Seoul, Korea
| | - Su-Jin Shin
- Department of Pathology, College of Medicine, Hanyang University, Seoul, Korea
| |
Collapse
|
34
|
Skala SL, Ye JC, Stumph J, Macon WR, Quinones FR, Khachaturov V, Ketterling RP, Dewar R. Combined Tumors in Hematolymphoid Neoplasms: Case Series of Histiocytic and Langerhans Cell Sarcomas Arising From Low-Grade B-Cell Lymphoma. CLINICAL PATHOLOGY 2019; 12:2632010X19878410. [PMID: 31633108 PMCID: PMC6769199 DOI: 10.1177/2632010x19878410] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/04/2019] [Indexed: 12/11/2022]
Abstract
We report an index case of histiocytic sarcoma arising in a 70-year-old patient with long-standing chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The patient presented in 2017 with painful, enlarging swelling of the left neck. He had remote history of cutaneous squamous cell carcinoma with no sign of recurrence, and his CLL/SLL was thought to be in remission. Computed tomography showed mild splenomegaly and multifocal lymphadenopathy including a 3-cm left neck mass. Biopsy of the left neck mass showed CLL/SLL with associated histiocytic sarcoma. Flow cytometry demonstrated a B cell neoplasm with CLL/SLL phenotype. Despite radiation therapy, he expired 3 months after presentation. Two similar cases (CLL/SLL and histiocytic sarcoma, follicular lymphoma and Langerhans cell sarcoma) from another institution are also illustrated. The pathological features of combined tumors in lymphoid neoplasms, a general framework to the work-up to determine interrelatedness of tumor components, and the clinical relevance are discussed.
Collapse
Affiliation(s)
- Stephanie L Skala
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Jing C Ye
- Division of Hematology and Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer Stumph
- Michigan Pathology Specialists, Spectrum Health, Grand Rapids, MI, USA
| | - William R Macon
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | - Vadim Khachaturov
- Michigan Pathology Specialists, Spectrum Health, Grand Rapids, MI, USA
| | - Rhett P Ketterling
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Rajan Dewar
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
35
|
Papoudou‐Bai A, Vassou A, Marinos L, Papathanasiou K, Kapsali E, Kanavaros P. Concurrent cutaneous localization of Langerhans cell sarcoma and chronic lymphocytic leukemia/small lymphocytic lymphoma in a patient with a history of chronic lymphocytic leukemia/small lymphocytic lymphoma. J Cutan Pathol 2019; 47:161-165. [DOI: 10.1111/cup.13571] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 08/11/2019] [Accepted: 08/19/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Alexandra Papoudou‐Bai
- Department of Pathology, Faculty of Medicine, School of Health SciencesUniversity of Ioannina Ioannina Greece
| | - Amalia Vassou
- Department of Hematology, Faculty of Medicine, School of Health SciencesUniversity of Ioannina Ioannina Greece
| | - Leonidas Marinos
- Department of HematopathologyEvangelismos General Hospital Athens Greece
| | - Konstantina Papathanasiou
- Department of Hematology, Faculty of Medicine, School of Health SciencesUniversity of Ioannina Ioannina Greece
| | - Eleni Kapsali
- Department of Hematology, Faculty of Medicine, School of Health SciencesUniversity of Ioannina Ioannina Greece
| | - Panagiotis Kanavaros
- Department of Anatomy‐Histology‐Embryology, Faculty of Medicine, School of Health SciencesUniversity of Ioannina Ioannina Greece
| |
Collapse
|
36
|
Histiocytic sarcoma of the lymph node: a rare and aggressive hematolymphoid malignancy. Hematol Transfus Cell Ther 2019; 42:184-187. [PMID: 31439515 PMCID: PMC7248498 DOI: 10.1016/j.htct.2019.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/28/2019] [Accepted: 04/29/2019] [Indexed: 11/24/2022] Open
|
37
|
Abstract
Histiocytic and dendritic cell neoplasms are very rare, belonging to a group that share morphologic, immunophenotypic, and ultrastructural characteristics of mature histiocytic/dendritic neoplasms. Histiocytic and dendritic cell neoplasms may arise de novo or in association with B-cell, T-cell, or myeloid neoplasms. Recent molecular findings, particularly the discoveries of the mutations in the RAS-RAF-MEK-ERK pathway, have greatly advanced the diagnosis and treatment options. Histiocytic and dendritic cell neoplasms may closely resemble each other, non-hematopoietic neoplasms, and even reactive processes. Therefore, it is essential to understand the clinicopathologic characteristics, differential diagnoses, and pitfalls of each entity.
Collapse
Affiliation(s)
- Zenggang Pan
- Department of Pathology, Yale University School of Medicine, 310 Cedar Street, New Haven, CT 06510-3218, USA
| | - Mina L Xu
- Department of Pathology, Yale University School of Medicine, 310 Cedar Street, New Haven, CT 06510-3218, USA; Department of Laboratory Medicine, Yale University School of Medicine, 310 Cedar Street, New Haven, CT 06510-3218, USA.
| |
Collapse
|
38
|
Byers JT, French SW. An unexpected diagnosis of histiocytic sarcoma. Exp Mol Pathol 2018; 106:60-62. [PMID: 30502322 DOI: 10.1016/j.yexmp.2018.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/20/2018] [Accepted: 11/25/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Joshua T Byers
- Harbor-UCLA Medical Center, 1000 W. Carson St., Torrance, CA 90509, United States
| | - Samuel W French
- Harbor-UCLA Medical Center, 1000 W. Carson St., Torrance, CA 90509, United States.
| |
Collapse
|