title: Pulmonary crystal-storing histiocytoma.
abstract: We describe the case of a 50-year-old woman with a lung tumor composed of crystal-storing histiocytes. These cells and associated plasma cells failed to show clonal light chain restriction, and the patient had no associated hematologic disorder. The differential diagnosis included crystal-storing histiocytosis, characterized by accumulation of crystallized immunoglobulins, a rare manifestation of monoclonal gammopathies/plasma cell dyscrasias. Crystal-laden histiocytes have previously been described in many organs. Four reports have described crystal-storing histiocytosis in the lung, always associated with a lymphoproliferative disorder. The present patient, 1 other case from our archive, and 1 case reported in the literature, all without an association with lymphoproliferative disorder, make a full description and definition of this lesion appropriate. The morphology, immunohistochemical profile, and electron microscopic features are described herein, and the term pulmonary crystal-storing histiocytoma is proposed. A practical algorithm is presented for the assessment of solitary lung masses composed of large histiocytic cells.
authors.affiliation: Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. ionescudn@upmc.edu
authors.forename: Diana N
authors.initials: DN
authors.lastname: Ionescu
authors.forename: Diane M
authors.initials: DM
authors.lastname: Pierson
authors.forename: Gefei
authors.initials: G
authors.lastname: Qing
authors.forename: Maomi
authors.initials: M
authors.lastname: Li
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Colby
authors.forename: Kevin O
authors.initials: KO
authors.lastname: Leslie
mesh_terms: D000465:Algorithms; D014408:Biomarkers, Tumor; D003460:Crystallization; D003937:Diagnosis, Differential; D005260:Female; D006644:Histiocytes / Q000737:chemistry / Q000473:pathology* / Q000648:ultrastructure; D051642:Histiocytoma / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D015614:Histiocytosis / Q000175:diagnosis; D006801:Humans; D007124:Immunoenzyme Techniques; D007136:Immunoglobulins / Q000737:chemistry / Q000648:ultrastructure; D008175:Lung Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D008247:Lysosomes / Q000648:ultrastructure; D008875:Middle Aged; D010950:Plasma Cells
chemical_list: D014408:Biomarkers, Tumor; D007136:Immunoglobulins