Histiocytic sarcoma - a case with evenly distributed multinucleated giant cells.
Histiocytic sarcoma is an uncommon neoplasm of mature histiocytes with a poor clinical outcome. We report a case of a true histiocytic sarcoma with prominent and evenly distributed multinucleated giant cells that mimics a giant cell tumor of soft tissue. The tumor was located between the appendix, right ovary, and the terminal ileum with severe adhesion. The liver and spleen were not enlarged. Grossly, the tumor appeared grayish white, solid, and soft. Microscopically, polygonal mononuclear tumor cells aggregated to form somewhat epithelioid nests, which occasionally showed coagulative necrosis. Prominent and evenly scattered giant cells were present in all sections. In addition, tumor cell infiltration was noted in regional lymph nodes. The tumor cells were positive for lysozyme, CD68, CD163, and negative for T- and B-cell lineage markers, follicular dendritic cell, megakaryocytic, epithelial, muscular, and melanocytic markers, CD1a and CD30. This case posed great difficulty in clinical and pathological diagnoses. Gross pictures, microscopic findings, and extensive immunostains are important for the differential diagnosis.
Department of Pathology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta-Pei Rd, Niao-Sung Hasiang, Kaohsiung Hsien 833, Taiwan. shuang@cgmh.org.tw
Shun-Chen
SC
Huang
Chia-Lo
CL
Chang
Cheng-Hua
CH
Huang
Chung-Che Jeff
CC
Chang
D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D019070:Cell Lineage; D003937:Diagnosis, Differential; D005260:Female; D005870:Giant Cell Tumors / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D015726:Giant Cells / Q000737:chemistry / Q000473:pathology*; D006644:Histiocytes / Q000737:chemistry / Q000473:pathology*; D015620:Histiocytic Disorders, Malignant / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D006801:Humans; D009113:Muramidase / Q000032:analysis; D009361:Neoplasm Invasiveness; D012509:Sarcoma / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D015703:Antigens, CD; D009113:Muramidase