BACKGROUND Histiocytic sarcoma(HS)of the spleen is reported to be a rare and lethal disease.The clinicopathological features of splenic HS have not been well described.The objective of this paper is to describe the di...BACKGROUND Histiocytic sarcoma(HS)of the spleen is reported to be a rare and lethal disease.The clinicopathological features of splenic HS have not been well described.The objective of this paper is to describe the diagnosis and treatment of a case of this rare disease and provide a review of the literature.CASE SUMMARY In this article,we discuss the case of a 40-year-old Hispanic female who presented with progressive thrombocytopenia and multiple hypoechoic lesions in the spleen without splenomegaly.Positron emission tomography-computed tomography showed increased activity in cervical lymph nodes,as well as multiple bone and splenic lesions with positive uptake.Two bone marrow biopsies and fine-needle aspiration of the cervical lymph node were inconclusive.Laparoscopic splenectomy was performed,and gross examination showed a 110.1 g spleen with multiple rubbery,nodular lesions within the subcapsular sinus and splenic parenchyma.The microscopic findings showed multinodular histiocyte proliferation with atypia and multilobulated nuclei,which were positive for CD163,CD4,and CD68 by immunohistochemical analysis.The final pathologic diagnosis was difficult and was found to be low-grade HS of the spleen,after consultations with two renowned hematopathology institutions.At the patient’s five-month follow-up visit,her bone marrow metastasis had progressed.She is waiting to be enrolled in a clinical trial.CONCLUSION Pathologic diagnosis of splenic HS can be challenging.Low-grade differentiation may be associated with a slow progressive disease.展开更多
In this article,a case of histiocytic sarcoma(HS) arising from tonsil in a 60 year-old male patient was reported.Consideried a local disease,a regime consisting of 4 cycles of(CHOP) associated with radiotherapy was us...In this article,a case of histiocytic sarcoma(HS) arising from tonsil in a 60 year-old male patient was reported.Consideried a local disease,a regime consisting of 4 cycles of(CHOP) associated with radiotherapy was used.A positive result was gained after treatment.But HS is a rare hematopoietic neoplasm derived from hematopoietic monoblasts with aggressive characteristic and poor outcome.Stage of disease and tumor size are possibly associated with the prognosis.展开更多
Histiocytic sarcoma is an extremely rare and very aggressive malignancy, with poor prognosis. The cases described in the literature are few and the treatment is not currently considered consensual. The clinical presen...Histiocytic sarcoma is an extremely rare and very aggressive malignancy, with poor prognosis. The cases described in the literature are few and the treatment is not currently considered consensual. The clinical presentation is very variable. Its characterization is made based primarily on the histology. The authors present a case of an 82-year-old woman, with multiple adenopatic retroperitoneal and left iliac conglomerates, with left leg associated edema (extrinsic compression by conglomerates). After intensive study and approach ganglion biopsy, the histologic diagnosis revealed a histiocytic sarcoma.展开更多
Histiocytic sarcoma is an uncommon non-Langerhans histiocyte disorder of mature tissue histiocytes.The authors presented an example of this rare tumor in a 14-year-old girl who presented with left upper quadrant pain,...Histiocytic sarcoma is an uncommon non-Langerhans histiocyte disorder of mature tissue histiocytes.The authors presented an example of this rare tumor in a 14-year-old girl who presented with left upper quadrant pain,loss of appetite,and weight loss.A large 18 cm×10 cm heterogeneous solid and cystic enhancing mass was found in the left lobe of the liver.Based on the histomorphology and positivity for histiocyte-specific markers in a needle biopsy,a diagnosis of histiocytic sarcoma was made.Chemotherapy was initiated,but the tumor did not respond well,and she died about 7 weeks following initial diagnosis with multi-organ failure.At autopsy,the tumor showed extensive necrosis,with no evidence of metastatic spread.In conclusion,the diagnosis of histiocytic sarcoma is challenging,and requires a high index of suspicion,with an appropriate panel of confirmatory immunohistochemical stains.Recognition of this rare tumor is important because of its poor response to chemotherapy and high mortality.展开更多
A 54-year-old man was admitted for the evaluation of fever and abodominal pain. Radiological and endo- scopic examination revealed a lung nodule and multiple small intestine uclers. Clinical diagnosis such as tubercul...A 54-year-old man was admitted for the evaluation of fever and abodominal pain. Radiological and endo- scopic examination revealed a lung nodule and multiple small intestine uclers. Clinical diagnosis such as tuberculosis and Crohn＇s disease had been proposed. He developed intestine perforation after small bowel endoscopic procedure. During emergent surgery the involved intestinal segments were resected and a pathological diagnosis of fibroblastic histiocytic sarcoma （FBRC） was made. The patient died in the sixth month after the operation. The management of this cases highlig^t~ the ~rawback of pattern recogn^tio~ as the most commonly used clinical reasoning method, and the importance of histological investigation.展开更多
BACKGROUND Germ cell tumors(GCTs)account for 2%of human malignancies but are the most common malignant tumors among males aged 15-35.Since 1983,an association between mediastinal GCT(MGCT)and hematologic malignancies ...BACKGROUND Germ cell tumors(GCTs)account for 2%of human malignancies but are the most common malignant tumors among males aged 15-35.Since 1983,an association between mediastinal GCT(MGCT)and hematologic malignancies has been recognized.CASE SUMMARY We report a case in which malignant histiocytosis was associated with mediastinal GCTs.The clinical data of a male patient with MGCT admitted to Beijing Children's Hospital were collected retrospectively.The patient was first diagnosed according to imaging and pathological features as having MGCT,and was treated with surgery and chemotherapy.One year after stopping chemotherapy,imaging showed metastases in the right supraclavicular,mediastinum,hilar region and retroperitoneal lymph node,right pleura,right lung,and right para-cardiac margin.Pathological diagnosis of the liver nodular and hilar lymph nodes included systemic juvenile xanthogranuloma and Rosai-Dorfman lesions with malignant transformation(i.e.,morphological characteristics and immunophenotype of histiocytic sarcoma).Following diagnosis,the patient accepted chemotherapy with vindesine,cytarabine and dexamethasone.Positron emission tomography–computed tomography showed partial remission.The patient was followed-up for 10 mo after the diagnosis of malignant histiocytosis,and no sign of progression or relapse was observed.CONCLUSION Physicians should recognize the possibility of hematologic malignancies being associated with MGCT.Suitable sites should be selected for pathological examination.展开更多
BACKGROUND Malignant splenic tumors are rare but fatal,presenting a challenge in diagnosis and management involving hematology,oncology,and general surgery.By contrast,diagnosing and treating other common malignant tu...BACKGROUND Malignant splenic tumors are rare but fatal,presenting a challenge in diagnosis and management involving hematology,oncology,and general surgery.By contrast,diagnosing and treating other common malignant tumors(such as lung and gastrointestinal cancer)offers multiple strategies for chemotherapy,radiotherapy,targeted therapy,and immunotherapy with the prospect of a cure.With various specialists involved in clinical multiple disciplinary team(MDT)discussion,personal bias can be minimized.It can also ignite important discussion which can benefit not only one patient but many patients.CASE SUMMARY Here,we report on the MDT diagnosis and management of the malignant splenic tumors littoral cell angiosarcoma and histiocytic sarcoma.Although only two cases of rare primary splenic malignancy are presented,MDT is a novel means of rare disease treatment.CONCLUSION To benefit patients,imaging analysis,safe operation,precise pathology examination,and individualized therapeutic treatment strategies are required.The involvement of various specialists in a clinical MDT discussion minimizes personal bias and can create important ideas to benefit all patients.展开更多
基金supported (in whole or part) by HCA Healthcare and/or an HCA Healthcare affiliated entity
文摘BACKGROUND Histiocytic sarcoma(HS)of the spleen is reported to be a rare and lethal disease.The clinicopathological features of splenic HS have not been well described.The objective of this paper is to describe the diagnosis and treatment of a case of this rare disease and provide a review of the literature.CASE SUMMARY In this article,we discuss the case of a 40-year-old Hispanic female who presented with progressive thrombocytopenia and multiple hypoechoic lesions in the spleen without splenomegaly.Positron emission tomography-computed tomography showed increased activity in cervical lymph nodes,as well as multiple bone and splenic lesions with positive uptake.Two bone marrow biopsies and fine-needle aspiration of the cervical lymph node were inconclusive.Laparoscopic splenectomy was performed,and gross examination showed a 110.1 g spleen with multiple rubbery,nodular lesions within the subcapsular sinus and splenic parenchyma.The microscopic findings showed multinodular histiocyte proliferation with atypia and multilobulated nuclei,which were positive for CD163,CD4,and CD68 by immunohistochemical analysis.The final pathologic diagnosis was difficult and was found to be low-grade HS of the spleen,after consultations with two renowned hematopathology institutions.At the patient’s five-month follow-up visit,her bone marrow metastasis had progressed.She is waiting to be enrolled in a clinical trial.CONCLUSION Pathologic diagnosis of splenic HS can be challenging.Low-grade differentiation may be associated with a slow progressive disease.
文摘In this article,a case of histiocytic sarcoma(HS) arising from tonsil in a 60 year-old male patient was reported.Consideried a local disease,a regime consisting of 4 cycles of(CHOP) associated with radiotherapy was used.A positive result was gained after treatment.But HS is a rare hematopoietic neoplasm derived from hematopoietic monoblasts with aggressive characteristic and poor outcome.Stage of disease and tumor size are possibly associated with the prognosis.
文摘Histiocytic sarcoma is an extremely rare and very aggressive malignancy, with poor prognosis. The cases described in the literature are few and the treatment is not currently considered consensual. The clinical presentation is very variable. Its characterization is made based primarily on the histology. The authors present a case of an 82-year-old woman, with multiple adenopatic retroperitoneal and left iliac conglomerates, with left leg associated edema (extrinsic compression by conglomerates). After intensive study and approach ganglion biopsy, the histologic diagnosis revealed a histiocytic sarcoma.
文摘Histiocytic sarcoma is an uncommon non-Langerhans histiocyte disorder of mature tissue histiocytes.The authors presented an example of this rare tumor in a 14-year-old girl who presented with left upper quadrant pain,loss of appetite,and weight loss.A large 18 cm×10 cm heterogeneous solid and cystic enhancing mass was found in the left lobe of the liver.Based on the histomorphology and positivity for histiocyte-specific markers in a needle biopsy,a diagnosis of histiocytic sarcoma was made.Chemotherapy was initiated,but the tumor did not respond well,and she died about 7 weeks following initial diagnosis with multi-organ failure.At autopsy,the tumor showed extensive necrosis,with no evidence of metastatic spread.In conclusion,the diagnosis of histiocytic sarcoma is challenging,and requires a high index of suspicion,with an appropriate panel of confirmatory immunohistochemical stains.Recognition of this rare tumor is important because of its poor response to chemotherapy and high mortality.
文摘A 54-year-old man was admitted for the evaluation of fever and abodominal pain. Radiological and endo- scopic examination revealed a lung nodule and multiple small intestine uclers. Clinical diagnosis such as tuberculosis and Crohn＇s disease had been proposed. He developed intestine perforation after small bowel endoscopic procedure. During emergent surgery the involved intestinal segments were resected and a pathological diagnosis of fibroblastic histiocytic sarcoma （FBRC） was made. The patient died in the sixth month after the operation. The management of this cases highlig^t~ the ~rawback of pattern recogn^tio~ as the most commonly used clinical reasoning method, and the importance of histological investigation.
文摘BACKGROUND Germ cell tumors(GCTs)account for 2%of human malignancies but are the most common malignant tumors among males aged 15-35.Since 1983,an association between mediastinal GCT(MGCT)and hematologic malignancies has been recognized.CASE SUMMARY We report a case in which malignant histiocytosis was associated with mediastinal GCTs.The clinical data of a male patient with MGCT admitted to Beijing Children's Hospital were collected retrospectively.The patient was first diagnosed according to imaging and pathological features as having MGCT,and was treated with surgery and chemotherapy.One year after stopping chemotherapy,imaging showed metastases in the right supraclavicular,mediastinum,hilar region and retroperitoneal lymph node,right pleura,right lung,and right para-cardiac margin.Pathological diagnosis of the liver nodular and hilar lymph nodes included systemic juvenile xanthogranuloma and Rosai-Dorfman lesions with malignant transformation(i.e.,morphological characteristics and immunophenotype of histiocytic sarcoma).Following diagnosis,the patient accepted chemotherapy with vindesine,cytarabine and dexamethasone.Positron emission tomography–computed tomography showed partial remission.The patient was followed-up for 10 mo after the diagnosis of malignant histiocytosis,and no sign of progression or relapse was observed.CONCLUSION Physicians should recognize the possibility of hematologic malignancies being associated with MGCT.Suitable sites should be selected for pathological examination.
基金Supported by the NSFC,No.81502696Technology Plan Program of Sichuan Province,No.2018JY0185+1 种基金Program of General Hospital of Western Theater,No.2021-XZYG-C3Science&Technology Department of Sichuan Province International Cooperation Program,No.2019YFH0056 and 2020YFSY0022。
文摘BACKGROUND Malignant splenic tumors are rare but fatal,presenting a challenge in diagnosis and management involving hematology,oncology,and general surgery.By contrast,diagnosing and treating other common malignant tumors(such as lung and gastrointestinal cancer)offers multiple strategies for chemotherapy,radiotherapy,targeted therapy,and immunotherapy with the prospect of a cure.With various specialists involved in clinical multiple disciplinary team(MDT)discussion,personal bias can be minimized.It can also ignite important discussion which can benefit not only one patient but many patients.CASE SUMMARY Here,we report on the MDT diagnosis and management of the malignant splenic tumors littoral cell angiosarcoma and histiocytic sarcoma.Although only two cases of rare primary splenic malignancy are presented,MDT is a novel means of rare disease treatment.CONCLUSION To benefit patients,imaging analysis,safe operation,precise pathology examination,and individualized therapeutic treatment strategies are required.The involvement of various specialists in a clinical MDT discussion minimizes personal bias and can create important ideas to benefit all patients.
