Moulignier Antoine, Mikol Jacqueline, Heran Françoise, Galicier Lionel
Service de Neurologie, Fondation Adolphe de Rothschild, Paris, France.
Service d'anatomie et cytologie pathologiques, Hôpital Lariboisière, APHP, Paris, France.
BMJ Case Rep. 2014 Aug 14;2014:bcr2014204663. doi: 10.1136/bcr-2014-204663.
Primary histiocytic sarcoma (HS) of the central nervous system (CNS) is a rare haematopoietic neoplasm. The inconsistent terminology and diagnostic criteria currently used for CNS HS have complicated the appreciation of the clinical aspects of the disease. The main differential diagnoses are non-Hodgkin's lymphoma, reactive histiocytic proliferation, dendritic cell neoplasm, undifferentiated carcinoma, inflammatory pseudotumour, Rosai-Dorfman disease and abscess. The true diagnosis of CNS HS requires an extensive immunophenotypic workup using specific histiocytic markers, such as CD163, with the exclusion of markers of other cell lineages. This clinicopathological case report describes an improved approach towards the differential diagnosis of CNS HS.
中枢神经系统原发性组织细胞肉瘤(HS)是一种罕见的造血系统肿瘤。目前用于中枢神经系统HS的术语和诊断标准不一致,这使得对该疾病临床特征的认识变得复杂。主要鉴别诊断包括非霍奇金淋巴瘤、反应性组织细胞增生、树突状细胞瘤、未分化癌、炎性假瘤、罗萨伊-多夫曼病和脓肿。中枢神经系统HS的准确诊断需要使用特定的组织细胞标志物(如CD163)进行广泛的免疫表型检查,并排除其他细胞谱系的标志物。本临床病理病例报告描述了一种改进的中枢神经系统HS鉴别诊断方法。