Case Report

International Journal of Hematology

, Volume 92, Issue 1, pp 168-173

Histiocytic sarcoma and underlying chronic myelomonocytic leukemia: a proposal for the developmental classification of histiocytic sarcoma

  • Minako MoriAffiliated withDepartment of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital
  • , Akiko MatsushitaAffiliated withDepartment of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital
  • , Yohko TakiuchiAffiliated withDepartment of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital
  • , Hiroshi ArimaAffiliated withDepartment of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital
  • , Seiji NaganoAffiliated withDepartment of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital
  • , Sonoko ShimojiAffiliated withDepartment of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital
  • , Takaharu KimuraAffiliated withDepartment of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital
  • , Daichi InoueAffiliated withDepartment of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital
  • , Sumie TabataAffiliated withDepartment of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital
    • , Sohshi YanagitaAffiliated withDepartment of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital
    • , Kenichi NagaiAffiliated withDepartment of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital
    • , Yukihiro ImaiAffiliated withDepartment of Clinical Pathology, Kobe City Medical Center General Hospital
    • , Takayuki TakahashiAffiliated withDepartment of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital Email author 

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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.

Keywords

Histiocytic sarcoma Chronic myelomonocytic leukemia Monocytic neoplasm Transformation 8 Trisomy Tetraploidy