Kushwaha Pritika, Singh Meeta, Datwani Sneha, Mallya Varuna, Singh Sarika, Aggarwal Sunita
Department of Pathology, Maulana Azad Medical College, New Delhi, India.
Department of Medicine, Maulana Azad Medical College, New Delhi, India.
Diagn Cytopathol. 2022 Oct;50(10):E306-E309. doi: 10.1002/dc.25003. Epub 2022 Jun 22.
Histiocytic sarcoma (HS) is a malignant neoplasm of hematopoietic origin. It is an exceedingly rare and aggressive malignancy commonly seen in adults. Diagnosis is difficult owing to lack of specific clinical manifestations with the absence of precursor lesions or causative agents. Hence, it primarily relies on histopathological morphology combined with immunohistochemistry, which is time-consuming, hence resulting in delayed treatment. However, diagnostic utility of flow cytometry is not well established in this. We report a case of a 45-year-old man who presented with right axillary lymphadenopathy for 1 month. FNAC was performed on the axillary lymph node, which showed large, atypical lymphoid/histiocyte-like cells. On flow cytometry, these cells were CD64+, CD11c+, and CD45+ suggesting histiocytic sarcoma. Similar morphology was seen on incisional biopsy. On immunohistochemistry, the cells were negative for B and T cell markers, PAX5, EMA, CK, ALK, and CD1a and expressed CD68, S100, and CD11c. A diagnosis of histiocytic sarcoma was made. Hence, flow cytometry can be a highly effective and powerful tool for the early detection of HS and can help in prompt treatment, given its aggressive clinical course and low survival interval.
组织细胞肉瘤（HS）是一种造血系统来源的恶性肿瘤。它是一种极其罕见且侵袭性强的恶性肿瘤，常见于成年人。由于缺乏特异性临床表现，且无前体病变或致病因素，诊断较为困难。因此，其诊断主要依靠组织病理学形态结合免疫组织化学，这一过程耗时较长，从而导致治疗延迟。然而，流式细胞术在该疾病中的诊断效用尚未得到充分确立。我们报告一例45岁男性患者，其右腋窝淋巴结肿大1个月。对腋窝淋巴结进行了细针穿刺抽吸活检（FNAC），结果显示有大量非典型淋巴样/组织细胞样细胞。流式细胞术检测显示，这些细胞CD64+、CD11c+、CD45+，提示为组织细胞肉瘤。切取活检也发现了类似的形态学表现。免疫组织化学检测显示，这些细胞的B和T细胞标志物、PAX5、上皮膜抗原（EMA）、细胞角蛋白（CK）、间变性淋巴瘤激酶（ALK）和CD1a均为阴性，而表达CD68、S100和CD11c。最终诊断为组织细胞肉瘤。鉴于组织细胞肉瘤临床病程侵袭性强、生存时间短，流式细胞术可为其早期检测提供一种高效且有力的工具，并有助于及时治疗。
