Histiocytic sarcoma of the brain |
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Authors: | Spinderjeet Gill-Samra Thomas Ng Mark Dexter Mark Wong Najmun Nahar Katherine Allsopp Rose A. Boadle Winny Varikatt |
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Affiliation: | 1. Department of Tissue Pathology, Level 3, ICPMR, Westmead Hospital, Hawkesbury Rd, Westmead, New South Wales 2145, Australia;2. Department of Neurosurgery, Westmead Hospital, New South Wales, Australia;3. Department of Medical Oncology, Westmead Hospital, New South Wales, Australia;4. Department of Radiation Oncology, Westmead Hospital, New South Wales, Australia;5. Department of Palliative Care, Westmead Hospital, New South Wales, Australia;6. Department of Tissue Pathology, Electron Microscope Laboratory, Westmead Hospital, New South Wales, Australia;7. School of Medicine, University of Western Sydney, New South Wales, Australia;1. Cancer Research UK, Cambridge Cancer Research Institute, Robinson Way, Cambridge CB2 0RE, UK;2. The Department of Applied Mathematics and Theoretical Physics, Cambridge University, Cambridge, UK;3. Department of Neurosurgery and Brain Tumor and Neuro-Oncology Center, The Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA;4. Case Western Reserve University School of Medicine, Cleveland, Ohio, USA;1. Asklepios Hospital St Georg, Hamburg, Germany;2. Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Germany;3. Department Internal Medicine III, Municipal Hospital Chemnitz, Germany;4. Department Internal Medicine I, University of Cologne, Germany;5. Department Internal Medicine III, Ludwig-Maximilians University of Munich, Germany;6. Department Internal Medicine III, University of Ulm, Germany;7. Municipal Hospital, Karlsruhe, Germany;8. Carl-Thiem-Hospital, Cottbus, Germany;9. Department Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany;10. Department Internal Medicine C, University Hospital Greifswald, Germany;11. Department Radiotherapy, University Hospital Saarland, Homburg, Germany;12. Department Haematology and Oncology, University of Göttingen, Germany;13. Institute of Pathology, University of Würzburg, Germany;14. Department Internal Medicine I, University Hospital Saarland, Homburg, Germany;1. Department of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Pk Rd, L223A Portland, OR 27239, USA;2. Advocate Medical Group, Division of General and Vascular Surgery, Department of Surgery, Elgin, IL, USA;3. Department of Gastroenterology, Oregon Health and Science University, Portland, OR, USA;4. Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Oregon Health and Science University, Portland, OR, USA;1. Nuffield Department of Medicine, University of Oxford, Oxford University Hospital, Headley Way, Oxford, United Kingdom;2. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Hospital, Oxford, United Kingdom;3. Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;1. Department of Nuclear Medicine, Lausanne University Hospital, Rue du Bugnon 46, Lausanne 1011, Switzerland;2. Department of Radiology, Lausanne University Hospital, Rue du Bugnon 46, Lausanne 1011, Switzerland;1. Department of Cardiovascular Surgery, St. Luke’s International Hospital, Tokyo, Japan;2. Department of Infectious Disease, St. Luke’s International Hospital, Tokyo, Japan |
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Abstract: | Histiocytic sarcoma is a rare malignant neoplasm of the lympho-hematopoietic system that usually occurs in the skin, lymph nodes and intestinal tract. We present a 36-year-old woman with a rare histiocytic sarcoma with isolated central nervous system (CNS) involvement of multifocal circumscribed lesions. Biopsy of the brain lesions showed diffuse proliferation of pleomorphic histiocytes that were immunopositive for CD45, CD68 and CD163. Various cytokeratins and markers of lymphoma, melanoma, germ cell tumours and primary CNS tumours were negative. Examination of bone marrow trephine and a whole-body positron emission tomography scan showed no evidence of involvement of any other organ systems, thus establishing the primary nature of the lesion. The neoplastic cells uniquely showed eosinophilic globules within the cytoplasm, which were positive for CD68. These globules were shown by electron microscopy to be collections of lysosomes. A thorough discussion of the differential diagnosis and literature review is included. |
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