Davies Austin J, Daneshpajouhnejad Parnaz, Patwardhan Mugdha, Xu Zaizhen, Cox Darren P
Oral and Maxillofacial Surgery, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
Department of Pathology, Stanford Hospital, Palo Alto, USA.
Head Neck Pathol. 2025 May 15;19(1):62. doi: 10.1007/s12105-025-01780-4.
Transdifferentiation of hairy cell leukemia to histiocytic sarcoma (HS) has not been previously reported in the head and neck. Given the rarity of HS, it can pose a challenge to diagnose this aggressive malignancy.
A 93-year-old male with a complex medical history presented with symptomatic and mobile lower anterior teeth. No intraoral growth mass was present initially and radiographic examination showed a radiolucent lesion in the anterior mandible. An incisional biopsy under local anesthesia was performed and histopathologic examination revealed a malignant sarcoma which upon further clinical, immunohistochemical, and molecular workup, confirmed the diagnosis.
Initial histopathologic evaluation of the biopsy rendered a provisional diagnosis of undifferentiated pleomorphic sarcoma. The case was referred to a tertiary care center for complete medical workup and additional ancillary studies where it was definitively diagnosed as a HS. The patient passed away a month after this HS diagnosis.
毛细胞白血病向组织细胞肉瘤（HS）的转分化此前在头颈部尚未见报道。鉴于HS罕见，诊断这种侵袭性恶性肿瘤可能具有挑战性。
一名有复杂病史的93岁男性，出现有症状且可活动的下前牙。最初口腔内未发现肿物，影像学检查显示下颌前部有一透射性病变。在局部麻醉下进行了切开活检，组织病理学检查显示为恶性肉瘤，经进一步临床、免疫组织化学和分子检查后确诊。
活检的初始组织病理学评估初步诊断为未分化多形性肉瘤。该病例被转诊至三级医疗中心进行全面的医学检查和其他辅助研究，最终确诊为HS。该患者在HS诊断后一个月去世。
