Cytological findings of langerhans cell sarcoma in a case of quintuple cancer

Abstract

Langerhans cell sarcoma (LCS) and quintuple cancers are extremely rare. In this report, a case of quintuple cancers including LCS was described. An 80‐year‐old man had squamous cell carcinoma of the nasal skin, colon and rectum adenocarcinomas, and T‐cell/histiocyte‐rich large B‐cell lymphoma. As swelling of multiple submental lymph nodes was observed, fine‐needle aspiration was carried out. Many large cells with high‐grade nuclear atypia and abundant cytoplasm were observed. Lymphocytes and eosinophils were observed in the background. Although a malignant tumor was suspected, a definite diagnosis could not be made. In a biopsy sample, the tumor cells were positive for vimentin, CD68, S‐100, CD1a, and CD163 and negative for epithelial, lymphocyte, and melanoma markers in immunohistochemistry. A diagnosis of LCS was made from the immunohistochemical findings and high mitotic rate with atypical forms. The patient died about 2 months after the first medical examination. Metastasis of LCS was confirmed in many organs by autopsy. LCS has a poor prognosis. In cases with the above‐described cytological findings, LCS should be added to the list of differential diagnosis. The cytological findings presented here may be useful for determining appropriate clinical management such as staging of the disease and follow‐up of the neoplasm. Diagn. Cytopathol. 2017;45:441–445. © 2017 The Authors Diagnostic Cytopathology Published by Wiley Periodicals, Inc.

Liquid‐based cytology in the diagnosis of Langerhans cell sarcoma: A case report

“…The commonly affected sites were lymph nodes, skin, lung, liver, and spleen, and approximately 40% of patients had multiorgan involvement . Although there have been a few reports of cytology findings in LCS, all relied on conventional rather than liquid‐based cytology.…”

“…Immunochemical analysis for histiocytic and dendritic cell markers is absolutely essential . Cytological diagnosis of a rare entity, such as LCS, is therefore difficult with conventional cytology techniques, with only a few cases reported . We report a case of LCS diagnosed using liquid‐based cytology of a fine needle aspiration sample from a lymph node, and review the cytological and immunocytochemical findings of LCS in liquid‐based cytology compared with conventional cytology.…”