Mastrorilli Cinzia, Spangler Elizabeth A, Christopherson Peter W, Aubry Oceane A, Newton Joseph C, Smith Annette N, Kennis Robert A, Weismann Jaime L, Moore Peter F
Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA.
Vet Clin Pathol. 2012 Sep;41(3):412-8. doi: 10.1111/j.1939-165X.2012.00449.x. Epub 2012 Jun 29.
A 9-month-old male Great Dane had progressive generalized nodular dermatopathy for several months. There were > 100 raised, alopecic, firm, painful nodules throughout the skin. Aspirates from several lesions yielded moderate numbers of irregularly round or polygonal to spindle-shaped cells with mild to moderate anisocytosis and few inflammatory cells, and the cytologic interpretation was proliferation of mesenchymal or histiocytic cells. On histopathologic examination, nodules were composed of densely packed sheets of round to spindle-shaped cells with mild anisokaryosis and low mitotic activity. Multifocal histiocytic sarcoma with a spindle-cell pattern was diagnosed based on morphologic features and intense expression of CD18. Additional immunophenotypic analysis on frozen sections of tissue confirmed the diagnosis of histiocytic sarcoma; expression of CD18, CD45, CD1a, CD11b, and CD11c, limited expression of Thy-1 (CD90) and CD80, and lack of expression of CD4, CD11d, and CD86 indicated that the cells were likely interstitial dendritic cells; a review of reactive and neoplastic dendritic cells is provided. Based on staging, internal organs were not affected. Sequential treatment with lomustine and doxorubicin failed to prevent progression of the cutaneous lesions, and the dog died 3 months after initial diagnosis. At necropsy, a focus of neoplastic cells was present in one lymph node, but except for skin other organs were not involved. The clinical presentation of histiocytic sarcoma may be unusual, and neoplastic cells may lack overt features of malignancy on cytologic and histopathologic examination. In some instances, immunophenotyping is required to differentiate histiocytic sarcoma from other histiocytic disorders.
一只9个月大的雄性大丹犬出现进行性全身性结节性皮肤病已有数月。全身皮肤有100多个隆起、脱毛、坚实、疼痛的结节。对多个病变部位进行穿刺，获得了中等数量的不规则圆形、多边形至梭形细胞，有轻度至中度的细胞大小不等，炎症细胞较少，细胞学诊断为间充质或组织细胞增生。组织病理学检查显示，结节由密集排列的圆形至梭形细胞片组成，有轻度核大小不等，有丝分裂活性低。根据形态学特征和CD18的强烈表达，诊断为多灶性梭形细胞型组织细胞肉瘤。对组织冰冻切片进行的额外免疫表型分析证实了组织细胞肉瘤的诊断；CD18、CD45、CD1a、CD11b和CD11c的表达，Thy-1（CD90）和CD80的有限表达，以及CD4、CD11d和CD86的不表达表明这些细胞可能是间质树突状细胞；本文提供了反应性和肿瘤性树突状细胞的综述。根据分期，内脏器官未受影响。用洛莫司汀和阿霉素序贯治疗未能阻止皮肤病变的进展，这只狗在初诊后3个月死亡。尸检时，一个淋巴结中有肿瘤细胞灶，但除皮肤外其他器官未受累。组织细胞肉瘤的临床表现可能不寻常，肿瘤细胞在细胞学和组织病理学检查中可能缺乏明显的恶性特征。在某些情况下，需要进行免疫表型分析以将组织细胞肉瘤与其他组织细胞疾病区分开来。
