192 T-Cell/Histiocyte-Rich Large B-Cell Lymphoma (THRLBCL)—An Unusual Case in a Pediatric Patient (original) (raw)

Histiocytic Sarcoma Secondary to Gastrointestinal Stromal Tumors: A Literature Review

Cureus

Histiocytic sarcoma (HS) is a rare tumor that may result from the transdifferentiation of preexisting hematolymphoid neoplasms in a subset of patients. There are instances of correlation or concurrence between HS and a number of cancers, particularly B-cell-associated hematopoietic tumors. Only three cases of HS occurring subsequent to or concurrently with gastrointestinal stromal tumors (GIST) have been recorded. Our main objective was to give an overview of demographics, clinical signs and symptoms, histopathological findings, and immunohistochemical and molecular analysis when HS develops secondary to or concurrently with GIST. A search of PubMed, Google Scholar, and ScienceDirect was undertaken using Medical Subject Headings (MeSH) keywords. According to the findings of our review, there were two males (66.6%) and one female (33.3%). The average age of patients at presentation was 59.6 years. On the immunohistochemistry, three patients were positive for cluster of differentiation (CD) 68 (100%), two patients were positive for CD 163 (67%), one patient was positive for leukocyte common antigen (LCA) (33%), and only one patient was positive for CD 4, CD 10, CD 31, CD 45, human leukocyte antigen (HLA)-DR, lysozyme, and vimentin (33%). On molecular investigation, the gastric mass of only one patient (33.33%) contained a KIT mutation on exon 11. Emperipolesis was observed in one patient (33.33%) on histological examination. Our study provides an important overview of the available literature and gives insight into important diagnostic markers of HS when it occurs secondary to or concurrently with GIST.

T-cell/histiocyte-rich large B-cell lymphoma of stomach

JPMA. The Journal of the Pakistan Medical Association, 2016

T-cell/histiocyte-rich large B-cell lymphoma is an unusually encountered lymphoid neoplasm of stomach with aggressive course, and is an uncommon morphologic variant of diffuse large B-cell lymphoma. An ulcerated mass, 7x5x1 cm in size was observed within the gastrectomy specimen of a 76-year-old female patient. In cross sections, besides mature lymphoid cells displaying T-cell phenotype, a neoplastic formation composed of large, pleomorphic atypical lymphoid cells with, prominent nucleoli, vesicular nuclei and abundant eosinophilic cytoplasm displaying B-cell phenotype were observed. Meanwhile, histiocyte-like mononuclear cells and Reed-Sternberg-like multinuclear cells expressing CD68 and Mac387 were also observed. The diagnosis of the case was T cell/histiocyte-rich large B-cell lymphoma. This rarely encountered neoplasm should be kept in mind in the differential diagnosis of primary gastric lymphomas.

Malignant histiocytosis with associated “reticulum celled sarcoma”

The Journal of Pathology, 1977

MALIGNANT histiocytosis was first described as a distinct entity by Bodley-Scott and Robb-Smith (1939) under the name of histiocytic medullary reticulosis. Later accounts are those of Marshall (1954), Rappaport (1966) and Bryne and Rappaport (1971). The histological features of the condition are well recognised ; involving proliferation of usually well differentiated histiocytes but sometimes with nuclear atypia, and evidence of phagocytosis of erythrocytes, leucocytes and cell debris. In addition, a typical clinical syndrome of fever, malaise, wasting and a rapidly fatal course is also present. The following case presents the features of malignant histiocytosis associated with a gastric tumour of different morphology, resembling a " reticulum celled sarcoma ". This association does not appear to have been previously described. CASE REPORT P. T., a man aged 50 yr, with no relevant previous or family history, presented with a 12 months' history of pain in the right groin and hip, radiating down the right leg. A diagnosis of an inflammatory arthritis was made and he was treated with phenylbutazone with initial relief. Seven months before his final admission, the pain became worse and he developed night sweats. The pain and night sweats persisted and he developed pain in the right shoulder, weight loss, general malaise and anorexia. On admission to The London Hospital, he was a thin, anaemic man, with a liver palpable four fingers' breadths below the costal margin and tenderness over both iliac crests. No abnormality was found in the cardiovascular, respiratory or central nervous systems. No lymphadenopathy was present. No abnormality was noted on X-ray examination of the chest, skull or abdomen but increased activity was observed in a bone scan over both iliac bones. A barium meal, barium enema and intravenous pyelogram were all normal. A lymphangiogram showed extensive involvement of abdominal lymph nodes, suggesting a lymphoma. Laboratory investigations Haemaglobin 12.6 gm per dl. Total WBCs 9.5 x lO/9 per litre. ESR 76 mm per hr. Blood electrolytes normal. Blood urea 22 mg per dl. Alkaline phosphatase 48.6 units. Total serum proteins 78 g per litre. Albumin 3.6 g. Globulin 4.2 g. Protein strip normal. Blood calcium 2.6 m.mol/l. Blood phosphate 1-12 m.mol/l. Mantoux reaction 1 in 1000 negative. Latex test negative.

Pathological disorders of the gastric mucosa surrounding carcinomas and primary lymphomas

The American Journal of Gastroenterology, 2001

Gastritis, intestinal metaplasia, atrophy, and dysplasia are disorders that frequently precede the full development of gastric adenocarcinoma. On the other hand, primary gastric lymphomas seem to arise from mucosa-associated lymphoid tissue. It is well accepted that these histological changes are caused by Helicobacter pylori infection. The objective of this study is to determine the frequency and characteristics of epithelial and lymphoid tissue disorders of the gastric mucosa surrounding primary carcinomas and lymphomas. We studied 111 gastrectomies from patients harboring primary adenocarcinomas (30 intestinal and 30 diffuse type) and 51 gastric lymphomas. For comparative purposes, we analized 86 stomachs from patients who died of diseases other than gastric malignancies. Histopathological disorders of the gastric mucosa adjacent to primary neoplasms such as atrophy, intestinal metaplasia, and dysplasia were recorded. Lymphoid follicles were classified in two groups, with or without expansion. Expansion was characterized by increased size, irregular borders, enlarged marginal zone, and expanded germinal centers. Differences were statistically evaluated with chi2 and Fisher exact tests, odds ratio, and relative risk, with 95% CI. p values <0.05 were considered statistically significant. Most intestinal-type adenocarcinomas showed atrophy (76.6%) and intestinal metaplasia (86.6%) and less frequently, dysplasia (23.3%), in the surrounding gastric mucosa. Expansive lymphoid follicles were more frequent among lymphomas than in adenocarcinomas (56.8% vs 25%); however, a high percentage of lymphomas were also associated with atrophy (50.9%), intestinal metaplasia (62.7%), and rarely dysplasia (11.8%). On the contrary, diffuse-type adenocarcinoma displayed less frequently atrophy (33%), intestinal metaplasia (50%), and dysplasia (3%). Gastric mucosa from patients without any gastric neoplasia was almost normal (84%), whereas the remaining 16% showed, both or alone, atrophy and intestinal metaplasia. Histopathological disorders of the gastric mucosa are not specific for any neoplasm, but intestinal-type adenocarcinomas frequently showed atrophy, intestinal metaplasia, and not uncommonly, dysplasia of the surrounding non-neoplastic gastric mucosa. Diffuse-type adenocarcinomas did not frequently show such lesions. Primary lymphomas displayed expansive lymphoid follicles and also a high percentage of atrophy and intestinal metaplasia of the surrounding gastric mucosa. The presence of intestinal metaplasia, atrophy, and lymphoid follicles with expansion in endoscopic biopsies could suggest a higher suceptibility for the development of gastric intestinal-type adenocarcinoma or gastric lymphoma. Patients harboring such histopathological changes must receive eradication therapy against H. pylori and probably closer follow-up.