Abstract
A 70-year-old male was admitted because of back pain due to peri-vertebral tumors. The histologic picture of a needle-biopsied tumor specimen showed pleomorphic large cell infiltration into the collagen fibers. On immunohistochemistry, these abnormal cells were positive for CD68, CD163 and lysozyme but negative for CD1a, 21, 30, and S100. Flow cytometric analysis also demonstrated that these cells were positive for CD13, 14, 38, 45, 56, and HLA-DR. A bone marrow aspirate showed the marked infiltration of abnormal large cells with the same surface antigens as described above. A diagnosis of HS was made. He showed monocytosis in the peripheral blood of more than 1.0 × 109/L from presentation. The karyotype of bone marrow cells was 46,XY,+8. Fluorescent in situ hybridization (FISH) analysis with a probe for chromosome no. 8 showed that all these monocytes carried +8, indicating that he had another disorder of chronic myelomonocytic leukemia (CMML). FISH analysis with a probe for chromosome no. 12 demonstrated that the abnormal large cells in the bone marrow were all tetraploid, while analysis with the chromosome no. 8 probe showed more than 8 signals per cell, indicating that HS cells carried octasomy to decasomy of chromosome no. 8. These findings strongly suggest that HS in the present patient originated from underlying CMML.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Weiss LM, Grogan TM, Mueller-Hermelink H-K. Histiocytic sarcoma. In: Jeff ES, Harris NL, Stein H, Vardiman JW, et al., editors. World Health Organization classification of tumors: pathology and genetics of tumors of haematopoietic and lymphoid tissues. Lyon: International Agency for Research on Cancer Press; 2001. p. 278–9.
Doll DC, Grogan TM, Greenberg BR. Chronic myelomonocytic leukemia terminating as malignant histiocytosis. Hematol Pathol. 1987;1:183–9.
Van der Kwast TH, Van Dongen JJ, Michiels JJ, Hooijkaas H, Kappers MC, Hagemeijer A. T-lymphoblastic lymphoma terminating as malignant histiocytosis with rearrangement of immunoglobulin heavy chain gene. Leukemia. 1991;5:78–82.
Soslow RA, Eric Davis R, Warnke RA, Cleary ML, Kamel OW. True histiocytic lymphoma following therapy for lymphoblastic neoplasms. Blood. 1996;87:5207–17.
Bouabdallah R, Abéna P, Chetaille B, Aurran-Schleinitz T, Sainty D, Dubus P, et al. True histiocytic lymphoma following B-acute lymphoblastic leukaemia: case report with evidence for a common clonal origin in both neoplasmas. Br J Haematol. 2001;113:1047–50.
Dalle JH, Leblond P, Decouvelaere A, Yakoub-Agha I, Preudhomme C, Nelken B, et al. Efficacy of thalidomide in a child with histiocytic sarcoma following allogeneic bone marrow transplantation for T-ALL. Leukemia. 2003;17:2056–7.
Feldman AL, Minniti C, Santi M, Downing JR, Raffeld M, Jaffe ES. Histiocytic sarcoma after acute lymphoblastic leukaemia: a common clonal origin. Lancet Oncol. 2004;5:248–50.
McClure R, Khoury J, Feldman A, Ketterling R. Clonal relationship between precursor B-cell acute lymphoblastic leukemia and histiocytic sarcoma: a case report and discussion in the context of similar cases. Leuk Res. 2009;34:e71–3.
Costa da Cunha Castro E, Blazquez C, Boyd J, Correa H, de Chadarevian JP, Felgar RE, et al. Clinicopathologic features of histiocytic lesions following ALL, with a review of the literature. Pediatr Dev Pathol. 2009;30:1.
Wetzler M, Kurzrock R, Goodacre AM, McLaughlin P, Ku S, Talpaz M. Transformation of chronic lymphocytic leukemia to lymphoma of true histiocytic type. Cancer. 1995;76:609–17.
Alvaro T, Bosch R, Salvado MT, Piris MA. True histiocytic lymphoma of the stomach associated with low-grade B-cell mucosa-associated lymphoid tissue (MALT)-type lymphoma. Am J Surg Pathol. 1996;20:1406–11.
Fukunaga M, Kato H. Histiocytic sarcoma associated with idiopathic myelofibrosis. Arch Pathol Lab Med. 2004;128:1167–70.
Song SY, Ko YH, Ahn G. Mediastinal germ cell tumor associated with histiocytic sarcoma of spleen: case report of an unusual association. Int J Surg Pathol. 2005;13:299–303.
Suenaga M, Matsushita K, Kawamata N, Kukita T, Hamakawa Y, Gejima K, et al. True malignant histiocytosis with trisomy 9 following primary mediastinal germ cell tumor. Acta Haematol. 2006;116:62–6.
Feldman AL, Arber DA, Pittaluga S, Martinez A, Burke JS, Raffeld M, et al. Clonally related follicular lymphomas and histiocytic/dendritic cell sarcomas: evidence for transdifferentiation of the follicular lymphoma clone. Blood. 2008;111:5433–9.
Zhang D, McGuirk J, Ganguly S, Persons DL. Hisiocytic/dendritic cell sarcoma arising from follicular lymphoma involving the bone: a case report and review of literature. Int J Hematol. 2009;89:529–32.
Jang YH, Park CJ, Huh JR, Jang S, Chi HS. A case of histiocytic sarcoma diagnosed by bone marrow biopsy in a patient suffering from Fever for 8 months. Korean J Lab Med. 2009;29:282–5.
Yu L, Yang SJ. A case of primary histiocytic sarcoma arising from thyroid gland. Pathol Oncol Res. 2010;16:127–32.
Stacher E, Beham-Schmid C, Terpe HJ, Simiantonaki N, Popper HH. Pulmonary histiocytic sarcoma mimicking pulmonary Langerhans cell histiocytosis in a young adult presenting with spontaneous pneumothorax: a potential diagnostic pitfall. Virchows Arch. 2009;455:187–90.
El-Matary W, Thorburn K, Baillie C, Kokai G, Dalzell M. Histiocytic sarcoma presenting with chylous ascites in 1 7-month-old infant: a case report. J Pediatr Hematol Oncol. 2009;31:65–8.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Mori, M., Matsushita, A., Takiuchi, Y. et al. Histiocytic sarcoma and underlying chronic myelomonocytic leukemia: a proposal for the developmental classification of histiocytic sarcoma. Int J Hematol 92, 168–173 (2010). https://doi.org/10.1007/s12185-010-0603-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12185-010-0603-z