A case of histiocytic sarcoma presenting with primary bone marrow involvement.
Histiocytic sarcoma (HS) is a very rare neoplasm that often shows an aggressive clinical course and systemic symptoms, such as fever, weight loss, adenopathy, hepatosplenomegaly and pancytopenia. It may present as localized or disseminated disease. We describe here a 63-yr-old male who manifested systemic symptoms, including fever, weight loss and generalized weakness. Abdominal and chest computed tomography failed to show specific findings, but there was suspicion of multiple bony changes at the lumbar spine. Fusion whole body positron emission tomography, bone scan and lumbar spine magnetic resonance imaging showed multiple bone lesions, suggesting a malignancy involving the bone marrow (BM). Several BM and bone biopsies were inconclusive for diagnosis. Necropsy showed replacement of the BM by a diffuse proliferation of neoplastic cells with markedly increased cellularity (95%). The neoplastic cells were positive for lysozyme and CD68, but negative for T- and B-cell lineage markers, and megakaryocytic, epithelial, muscular and melanocytic markers. Morphologic findings also distinguished it from other dendritic cell neoplasms.
Sohn
Byeong Seok
BS
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kim
Tark
T
Kim
Jeong Eun
JE
Bae
Eunsin
E
Park
Chan-Jeoung
CJ
Huh
Jooryung
J
Lee
Sang-Oh
SO
D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D019046:Bone Marrow Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D054747:Histiocytic Sarcoma / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009113:Muramidase / Q000378:metabolism; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D000097382:CD68 Molecule
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D009113:Muramidase; C067980:CD68 antigen, human; D000097382:CD68 Molecule