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Primary histiocytic sarcoma arising in the head and neck with predominant spindle cell component.

Alexiev BA, Sailey CJ, McClure SA, Ord RA, Zhao XF, Papadimitriou JC - Diagn Pathol (2007)

Bottom Line: Sheets, fascicles, and whorls of spindle cells with spindled to ovoid vesicular nuclei, small to medium-sized distinct nucleoli, and eosinophilic cytoplasm were frequently observed.Focal expression of CD4 and S-100 was also noted.Chromosome study revealed a 57-80 hyperdiploid [7]/46, XY [13] karyotype, including 3 to 4 copies of various chromosomes.

View Article: PubMed Central - HTML - PubMed

Affiliation: University of Maryland Medical Center, Department of Pathology, NBW43, 22 S Greene Street, Baltimore, MD 21201, USA. balexiev@umm.edu

ABSTRACT
This is the first case report of Histiocytic Sarcoma (HS) with predominant spindle cell component occurring in the head and neck region of a 41-year-old man. The tumor was composed of sheets of large round to oval cells with pleomorphic vesicular nuclei, prominent nucleoli and abundant eosinophilic cytoplasm. Multinucleated forms, numerous mitoses, and tumor necrosis were also noted. Sheets, fascicles, and whorls of spindle cells with spindled to ovoid vesicular nuclei, small to medium-sized distinct nucleoli, and eosinophilic cytoplasm were frequently observed. Immunohistochemical staining in the tumor cells was positive for CD163, CD68, lysozyme, CD45, and NSE. Focal expression of CD4 and S-100 was also noted. Electron microscopy demonstrated an abundance of lysosomes in the cytoplasm of tumor cells. Chromosome study revealed a 57-80 hyperdiploid [7]/46, XY [13] karyotype, including 3 to 4 copies of various chromosomes. The immunohistochemical and ultrastructural findings confirmed the diagnosis of HS.

No MeSH data available.


Related in: MedlinePlus

Histiocytic sarcoma. Axial CT scan showing a destructive lesion of the left mandible with invasion of the surrounding musculature.
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Figure 1: Histiocytic sarcoma. Axial CT scan showing a destructive lesion of the left mandible with invasion of the surrounding musculature.

Mentions: In October of 2006 a 41-year-old otherwise healthy man presented to the University of Maryland, Department of Oral and Maxillofacial Surgery for an evaluation of an expansile mass in the left zygomatic, preauricular region. Five months earlier the patient complained of headaches and increasing fatigue at the end of a normal work day. He then noticed increasing left jaw pain and trismus along with the headaches. He was seen and evaluated by his primary care physician. Initially he was treated for temporomandibular disorder. However, the patient's symptoms failed to subside and subsequently he was referred to an oral and maxillofacial surgeon. Computed tomography of his head and neck was obtained, revealing a destructive mass in the left condyle (Fig. 1). He was subsequently referred to the University of Maryland Medical Center for definitive treatment.


Primary histiocytic sarcoma arising in the head and neck with predominant spindle cell component.

Alexiev BA, Sailey CJ, McClure SA, Ord RA, Zhao XF, Papadimitriou JC - Diagn Pathol (2007)

Histiocytic sarcoma. Axial CT scan showing a destructive lesion of the left mandible with invasion of the surrounding musculature.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1808440&req=5

Figure 1: Histiocytic sarcoma. Axial CT scan showing a destructive lesion of the left mandible with invasion of the surrounding musculature.
Mentions: In October of 2006 a 41-year-old otherwise healthy man presented to the University of Maryland, Department of Oral and Maxillofacial Surgery for an evaluation of an expansile mass in the left zygomatic, preauricular region. Five months earlier the patient complained of headaches and increasing fatigue at the end of a normal work day. He then noticed increasing left jaw pain and trismus along with the headaches. He was seen and evaluated by his primary care physician. Initially he was treated for temporomandibular disorder. However, the patient's symptoms failed to subside and subsequently he was referred to an oral and maxillofacial surgeon. Computed tomography of his head and neck was obtained, revealing a destructive mass in the left condyle (Fig. 1). He was subsequently referred to the University of Maryland Medical Center for definitive treatment.

Bottom Line: Sheets, fascicles, and whorls of spindle cells with spindled to ovoid vesicular nuclei, small to medium-sized distinct nucleoli, and eosinophilic cytoplasm were frequently observed.Focal expression of CD4 and S-100 was also noted.Chromosome study revealed a 57-80 hyperdiploid [7]/46, XY [13] karyotype, including 3 to 4 copies of various chromosomes.

View Article: PubMed Central - HTML - PubMed

Affiliation: University of Maryland Medical Center, Department of Pathology, NBW43, 22 S Greene Street, Baltimore, MD 21201, USA. balexiev@umm.edu

ABSTRACT
This is the first case report of Histiocytic Sarcoma (HS) with predominant spindle cell component occurring in the head and neck region of a 41-year-old man. The tumor was composed of sheets of large round to oval cells with pleomorphic vesicular nuclei, prominent nucleoli and abundant eosinophilic cytoplasm. Multinucleated forms, numerous mitoses, and tumor necrosis were also noted. Sheets, fascicles, and whorls of spindle cells with spindled to ovoid vesicular nuclei, small to medium-sized distinct nucleoli, and eosinophilic cytoplasm were frequently observed. Immunohistochemical staining in the tumor cells was positive for CD163, CD68, lysozyme, CD45, and NSE. Focal expression of CD4 and S-100 was also noted. Electron microscopy demonstrated an abundance of lysosomes in the cytoplasm of tumor cells. Chromosome study revealed a 57-80 hyperdiploid [7]/46, XY [13] karyotype, including 3 to 4 copies of various chromosomes. The immunohistochemical and ultrastructural findings confirmed the diagnosis of HS.

No MeSH data available.


Related in: MedlinePlus