title: Cytological findings of langerhans cell sarcoma in a case of quintuple cancer.
abstract: Langerhans cell sarcoma (LCS) and quintuple cancers are extremely rare. In this report, a case of quintuple cancers including LCS was described. An 80-year-old man had squamous cell carcinoma of the nasal skin, colon and rectum adenocarcinomas, and T-cell/histiocyte-rich large B-cell lymphoma. As swelling of multiple submental lymph nodes was observed, fine-needle aspiration was carried out. Many large cells with high-grade nuclear atypia and abundant cytoplasm were observed. Lymphocytes and eosinophils were observed in the background. Although a malignant tumor was suspected, a definite diagnosis could not be made. In a biopsy sample, the tumor cells were positive for vimentin, CD68, S-100, CD1a, and CD163 and negative for epithelial, lymphocyte, and melanoma markers in immunohistochemistry. A diagnosis of LCS was made from the immunohistochemical findings and high mitotic rate with atypical forms. The patient died about 2 months after the first medical examination. Metastasis of LCS was confirmed in many organs by autopsy. LCS has a poor prognosis. In cases with the above-described cytological findings, LCS should be added to the list of differential diagnosis. The cytological findings presented here may be useful for determining appropriate clinical management such as staging of the disease and follow-up of the neoplasm. Diagn. Cytopathol. 2017;45:441-445. © 2017 The Authors Diagnostic Cytopathology Published by Wiley Periodicals, Inc.
authors.affiliation: Department of Pathology, Kushiro City General Hospital, Syunkodai 1-12, Kushiro, 085-0822, Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Tabata
authors.affiliation: Department of Pathology, Sapporo Medical University, School of medicine, South-1, West-17, Chuo-ku, Sapporo, 060-8556, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Murata
authors.affiliation: Department of Pathology, Sapporo Medical University, School of medicine, South-1, West-17, Chuo-ku, Sapporo, 060-8556, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Takasawa
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Fukuda
authors.affiliation: Department of Pathology, Kushiro City General Hospital, Syunkodai 1-12, Kushiro, 085-0822, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Ogasawara
authors.affiliation: Department of Pathology, Kushiro City General Hospital, Syunkodai 1-12, Kushiro, 085-0822, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Koseki
authors.affiliation: Department of Pathology, Kushiro City General Hospital, Syunkodai 1-12, Kushiro, 085-0822, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Nakano
authors.affiliation: Department of Surgical Pathology, Sapporo Medical University Hospital, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Segawa
authors.affiliation: Department of Pathology, Kushiro City General Hospital, Syunkodai 1-12, Kushiro, 085-0822, Japan.
authors.forename: Rena
authors.initials: R
authors.lastname: Morita
authors.affiliation: Department of Surgical Pathology, Sapporo Medical University Hospital, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Department of Pathology, Sapporo Medical University, School of medicine, South-1, West-17, Chuo-ku, Sapporo, 060-8556, Japan.
authors.forename: Norimasa
authors.initials: N
authors.lastname: Sawada
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000235:genetics / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D044963:Biopsy, Fine-Needle; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D054752:Langerhans Cell Sarcoma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D008297:Male; D009669:Nose Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D014746:Vimentin / Q000235:genetics / Q000378:metabolism
chemical_list: D015703:Antigens, CD; D014408:Biomarkers, Tumor; D014746:Vimentin
keywords: Langerhans cell sarcoma; fine-needle aspiration cytology; quintuple cancer; touch smear cytology