Cutaneous indeterminate cell histiocytosis: a new spindle cell variant resembling dendritic cell sarcoma.
BACKGROUND
Cutaneous indeterminate cell histiocytosis is a rare neoplastic disorder. Its varied histological presentation and rarity have limited efforts to determine its pathogenic relationship with other histiocytic lesions and possibly, its recognition.


METHODS
We report on an unusual histologic pattern of indeterminate cell histiocytosis that resembled follicular dendritic sarcoma. A battery of immunohistochemical stains and electron microscopy were performed to elucidate the phenotype of the "histiocytic" cells. Based on a review of the literature, reported cases of indeterminate cell histiocytosis are presented and the diagnostic differential of spindle-cell lesions is discussed.


RESULTS
Spindling histiocytes were positive for S-100 and CD1a. The monocytic/macrophage marker, CD68, and the dendritic cell marker, CD21, were negative. Electron microscopy failed to reveal Birbeck granules.


CONCLUSIONS
Relatively few reports of indeterminate cell histiocytosis exist, some of which include discussion of potential overlaps with the non-X histiocytoses. Although the presence of prominent spindling in our case expanded the differential to include non-histiocytic disorders, the identified histiocytes unequivocally fulfilled the criteria of S-100 and CD1a positivity without demonstrable Birbeck granules.
Rosenberg
A S
AS
Department of Pathology, University of South Florida, Tampa, Florida 33612, USA.
Morgan
M B
MB
D018949:Antigens, CD1 / Q000032:analysis; D020566:Dendritic Cells, Follicular / Q000473:pathology*; D003937:Diagnosis, Differential; D006644:Histiocytes / Q000737:chemistry / Q000473:pathology / Q000648:ultrastructure; D015614:Histiocytosis / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009418:S100 Proteins / Q000032:analysis; D012509:Sarcoma / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*
D018949:Antigens, CD1; C419393:CD1a antigen; D009418:S100 Proteins