Primary histiocytic sarcoma of the stomach: A case report with imaging findings

Shen, Xizhong; Liu, Fang; Ni, Rui-Jun; Wang, Boyin

doi:10.3748/wjg.v19.i3.422

Cited by 14 publications

(11 citation statements)

References 9 publications

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“…General remarks and clinical presentation: Histiocytic sarcoma (HS) may affect all age groups, but has its highest incidence in the 5th decade of life. The majority of patients present with tumor bulks, mostly in lymph nodes, but also in extralymphatic organs, such as the skin [68,208] and the gastrointestinal tract [7,80,94,186,234]. Less often, primary lung disease resembling pulmonary LCH [196], and primary parotid gland involvement have been described [6].…”

Section: Histiocytic Sarcoma (Histiocytic Mh)mentioning

confidence: 99%

The Non-Langerhans Cell Histiocytoses (Rare Histiocytoses) – Clinical Aspects and Therapeutic Approaches

2016

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Rare histiocytoses, also called non-Langerhans cell histiocytoses, include all proliferative disorders of histiocytes, macrophages and dendritic cells that are not classified as Langerhans cell histiocytosis (LCH) and do not belong to the hemophagocytic lymphohistiocytosis (HLH) group of diseases. Thus, the term includes numerous benign or malignant, localized or systemic, adult or pediatric diseases. The classification of the histiocytic disorders has been revised several times. Here, we follow the classification recently published by Jean Francois Emile and an international expert panel, defining subgroups of histiocytoses described as L-Group, C-Group, M-Group, R-Group, and H-Group, which stands for LCH-like, cutaneous or mucocutaneous, malignant, Rosai-Dorfman-Disease like and HLH like. Some of the diseases have an excellent prognosis after resection or even disappear spontanously, others progress rapidly, requiring intensive systemic therapies. The malignant non-Langerhans cell histiocytoses in general have a poor prognosis, here, complex chemotherapy protocols are usually applied, with inconsistant results. An interesting perspective in non-malignant rare histiocytoses might be small molecular inhibitors, in particular BRAF inhibitors, since BRAF mutations have been found in some subtypes of non-Langerhans cell histiocytoses. By prospective and retrospective collection of experiences in a new registry (the "International Rare Histiocytic Disorders Registry", IRHDR), knowledge about these rare diseases might hopefully be improved.

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Section: Histiocytic Sarcoma (Histiocytic Mh)mentioning

confidence: 99%

The Non-Langerhans Cell Histiocytoses (Rare Histiocytoses) – Clinical Aspects and Therapeutic Approaches

2016

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“…7 However, immunostaining is not necessarily positive clinically in cases of G-CSFproducing tumors. 8,9 In the present case, the patient's G-CSF level fell to 22.9 pg/mL postoperatively, meaning that criteria 1 to 3 were fulfilled, and the lesion met the criteria for being a G-CSFproducing tumor.…”

Section: Discussionmentioning

confidence: 49%

A Case of G-CSF–Producing Histiocytic Sarcoma of the Stomach

Hanaoka

Jingu²,

Tochigi³

et al. 2015

International Surgery

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No reports have been published to date regarding primary gastric granulocyte colony-stimulating factor (G-CSF)-producing histiocytic sarcoma. We encountered a case of primary gastric histiocytic sarcoma that also fulfilled the criteria for a G-CSF-producing tumor. A 75-year-old man was diagnosed with gastric cancer with poorly differentiated adenocarcinoma. The patient's white blood cell count was elevated to 20,700/μL, and the G-CSF level was elevated to 380 pg/mL. A computed tomography scan showed hepatic infiltration; therefore, a preoperative diagnosis of T4 (liver) N2H0M0 cStage IV gastric cancer was made, and surgery was performed. No. 11d lymphatic metastasis was noted, resulting in invasion of the pancreatic tail, and combined resection of the liver, pancreas, and spleen was conducted with complete gastrectomy. The results of hematoxylin-eosin and immunohistochemical staining were subsequently assessed. On discharge, the G-CSF level had fallen to 22.7 pg/mL. Currently, the patient is still alive and has experienced no recurrence approximately 4 years after the operation.

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“…The one additional case involved a common bile duct mass mimicking choledococholelitiasis . Since this review article, one additional case study has reported histiocytic sarcoma of the espophagus and 2 additional cases were reported in the stomach . To our knowledge, no cases cases of histiocytic sarcoma of the pancreatic parenchyma and no cases of histiocytic sarcoma of the pancreas diagnosed by cytopathology have been reported, including through EUS‐FNA.…”

Section: Discussionmentioning

confidence: 89%

Fine‐needle aspiration findings of a rare hematopoietic neoplasm presenting as obstructive jaundice

Tracht

Ahmed

Donath

2017

Diagnostic Cytopathology

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A 51-year-old female who presented with obstructive jaundice was found to have masses in the pancreatic head and tail as well as suspicious liver and periaortic masses on imaging. Aspiration cytology of the pancreatic tail mass showed abundant large single cells with vacuolated eosinophilic cytoplasm, marked nuclear pleomorphism, large bizarre irregular nuclei, binucleation, and prominent nucleoli. Numerous cells also showed intracytoplasmic black to brown pigmentation. A cell block was obtained and extensive immunohistochemical staining was performed. S-100, HMB-45, Sox10, pancytokeratin, CK7, RCC antigen, synaptophysin, HepPar 1, inhibin, CD45, CD21, and CD123 were negative, making melanoma, epithelial malignancies, lymphoma, follicular dendritic and plasmacytoid dendritic cell neoplasms less likely. CD4 and CD56 showed partial positivity, and CD68, CD163, and CD14 were positive, supporting the diagnosis of histiocytic sarcoma. Surgical specimens and immunohistochemistry confirmed the cytologic findings. Histiocytic sarcoma is a rare aggressive malignancy of histiocytic origin with most cases presenting in adults in extranodal sites, most commonly the intestinal tract. Few cases are reported in the literature, presenting diagnostic challenges for cytopathologists when seen on fine-needle aspiration. We present the first reported case of histiocytic sarcoma presenting as a pancreatic mass, diagnosed by endoscopic ultrasound guided fine-needle aspiration (EUS-FNA). This entity is rarely described on cytology and arose in a location in which EUS-FNA is the diagnostic modality of choice. This case study highlights that cytopathologists should be aware of histiocytic sarcoma occurring in extranodal locations accessible by EUS-FNA and be familiar with the cytomorphologic appearance.

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Primary histiocytic sarcoma of the stomach: A case report with imaging findings

Cited by 14 publications

References 9 publications

The Non-Langerhans Cell Histiocytoses (Rare Histiocytoses) – Clinical Aspects and Therapeutic Approaches

The Non-Langerhans Cell Histiocytoses (Rare Histiocytoses) – Clinical Aspects and Therapeutic Approaches

A Case of G-CSF–Producing Histiocytic Sarcoma of the Stomach

Fine‐needle aspiration findings of a rare hematopoietic neoplasm presenting as obstructive jaundice

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