Pérez GY, Pagura L, Fiandesio C, Cortés LL

Idioma: Español
Referencias bibliográficas: 29
Paginas: 220-225
Archivo PDF: 188.31 Kb.

RESUMEN

El sarcoma histiocítico es un tumor definido por la OMS como una proliferación celular maligna con inmunofenotipo y morfología que presentan diferenciación histiocítica. Caso clínico: hombre de 37 años que presentó pérdida de peso y cuadro diarreico de 6 meses de evolución. El estudio ecográfico mostró una tumoración esplénica sólida que fue extirpada. Al estudio histológico se observó una proliferación celular pleomórfica con áreas fusiformes que se disponían en haces y áreas de crecimiento sólido. Con inmunohistoquímica se encontró positividad para CD68, CD4, lisozima, alfa 1 antitripsina y vimentina. Los sarcomas histiocíticos representan menos de 1% de todos los tumores que afectan a los ganglios linfáticos y a las partes blandas. Es muy infrecuente su localización esplénica y su etiología se desconoce. Se manifiestan como tumores únicos asociados con síntomas sistémicos y el pronóstico es malo.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Kempson RL, Fletcher CDM, Evans HL, Hendrickson MR, Sibley RK. Fibrous Histiocytomas. Tumors of Soft Tissue. Washington, D.C: Armed Forces Institute of Pathology, 2001 pp: 113-79.

2. Oka K, Nakamine H, Maeda K, Yamakawa M, Tanaka I, et al. Primary histiocytic sarcoma of the spleen associated with hemophagocytosis. Int J Hematol 2008;87:405-9.

3. Jaffe ES. Histiocytoses of lymph nodes: biology and differential diagnosis. Semin Diagn Pathol 1988;5:376-90.

4. Hornick JL, Jaffe ES, Fletcher CD. Extranodal histiocytic sarcoma: clinicopathologic analysis of 14 cases of a rare epithelioid malignancy. Am J Surg Pathol 2004;28:1133-44.

5. Fletcher CDM, van den Berg E, Molenaar WM. Pleomorphic malignant fibrous histiocytoma/Undifferentiated high grade Pleomorphic Sarcoma. En: Tumors of Soft Tissue and Bone. World Health Organization Classification of Tumors. 2nd Ed. Lyon: IARC; 2002. pp: 118-25.

6. Rappaport H. Histiocytosis. In: Atlas of tumour pathology: Tumors of the haematopoietic system. Sec 3, fasc 8. Washington, DC: Armed Forces Institute of Pathology, 1966; pp: 48–63.

7. Sun W, Nordberg ML, Fowler MR. Histiocytic sarcoma involving the central nervous system: clinical, immunohistochemical, and molecular genetic studies of a case with review of the literature. Am J Surg Pathol 2003;27:258–265.

8. Rosai J. Soft Tissues. In: Rosai J. Ackerman’s Surgical Pathology 9ªed. St. Louis: Mosby; 2004; pp: 2237-73.

9. Jacobsen E. Histiocytic Sarcoma. UpToDate. (Última actualización: June 7, 2011. Consultado 10 de noviembre 2011). Disponible en http://www.uptodate.com/contents/histiocyticsarcoma.

10. Camarasa Lillo N, Roselló Sastre E, Palmeiro Uriach A, García Cosío-Piqueras M, y col. Sarcoma histiocítico con rasgos inmunohistoquímicos y ultraestructurales de células dendríticas interdigitantes. Rev Esp Patol 2008;41:237-241.

11. Pileri SA, Grogan TM, Harris NL, Banks P, Weiss L, et al. Tumours of histiocytes and accesory dendritic cells: an immunohistochemical approach to classification from the International Lymphoma Study Group based on 61 cases. Histopathology 2002;41:1-29.

12. Franchino C, Reich C, Distenfeld A, Ubriaco A, Knowles D. A Clinicopathologically Distinctive Primary Splenic Histiocytic Neoplasm: Demonstration of Its Histiocytic Derivation by Immunophenotypic and Molecular Genetic Analysis. Am J Surg Pathol 1988;12:398-404.

13. Morris MW, Davey FR. Immunologic and cytochemical properties of histiocytic and mixed histiocytic-lymphocytic lymphomas. Am J Clin Pathol 1975;63:403-14.

14. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, et al. WHO Classification of Tumors of Haematopoietic and Lymphoid Tissues. Lyon: IARC 2007; pp: 356-357.

15. Low SE, Stafford JS. Malignant histiocytosis: a case report of a rare tumour presenting with spontaneous splenic rupture. J Clin Pathol 2006;59:770–772.

16. Audouin J, Vercelli-Retta J, Le Touneau A, Adida C, Diebold J, et al. Primary histiocytic sarcoma of the spleen associated with erythrophagocytic histiocytosis. Pathol Res Pract 2003;199:107-12.

17. Vos JA, Abbondanzo SL, Barekman CL, Andriko JW, Aguilera N, et al. Histiocytic sarcoma: a study of five cases including the histiocyte marker CD163. Mod Pathol 2005;18:693–704.

18. Mills JA, Gonzalez RG, Jaffe R. Case records of Massachusetts General Hospital. Case 25-2008: A 43-year-old man with fatigue and lesion sin the pituitary and cerebellum. N Engl J Med 2008;14:736-47.

19. Weitzman S, Jaffe R. Uncommon histiocytic disorders: the non-Langerhans cell histiocytoses. Pediatr Blood Cancer 2005;45:256-64.

20. García-Gutiérrez M, Lara-Torres C, Ortiz-Hidalgo C. Sarcoma histiocítico. Estudio inmunohistoquímico de 6 casos. Rev Esp Patol 2011;44:202-208.

21. Shao H, Xi L, Raffeld M, Feldman AL, Jaffe E, et al. Clonally related histiocytic/dendritic cell sarcoma and chronic lymphocytic leukemia/small lymphocytic lymphoma: a study of seven cases. Mod Pathol 2011;24:1421-1432.

22. Feldman AL, Arber DA, Pittaluga S, Martinez A, Jaffe E, et al. Clonally related follicular lymphomas and histiocytic/dendritic cell sarcomas: evidence for transdifferentiation of the follicular lymphoma. Blood 2008;111:5433-543.

23. Kimura H, Nasu K, Sakai C, Shiga Y, Maruyama Y, et al. Histiocytic sarcoma ofthe spleen associated with hypoalbuminemia, hypo gamma globulinemia and thrombocytopenia as a possibly unique clinical entity--report of three cases. Leuk Lymphoma 1998;31:217-24.

24. Cheuk W, Walford N, Lou J, Lee A, Chan J, et al. Primary histiocytic lymphoma of the central nervous system: a neoplasm frequently overshadowed by a prominent inflammatory component. Am J Surg Pathol 2001;25:1372-9.

25. Copie-Bergman Ch, Wotherspoon AC, Norton AJ, Diss TC, Issacson PG. True histiocytic lymphoma. A morphologic, immunohistochemical, and molecular genetics study of 13 cases. Am J Surg Pathol 1998;22:1386-1392.

26. Dorfman DM, Hornick JL, Shahsafaei A, Freeman GJ. The phosphatidylserine receptors T cell immunoglobulin mucin proteins 3 and 4 are markers of histiocytic sarcoma and other histiocytic and dendritic cell neoplasms. Hum Pathol 2010;41:1486-94.

27. Mori M, Matsuchita A, Takiuchi Y, Arima H, Takahashi T, et al. Histiocytic sarcoma and underlying chronic myelomonocytic leukemia:a proposal for the developmental classification of histiocytic sarcoma. Int J Haematol 2010;92:168-73.

28. Hanson CA, Jaszcz W, Kersey JH, Astorga MG, Frizzera E, et al. True histiocytic lymphoma: histopathologic, immunophenotypic and genotypic analysis. Br J Haematol 1989;73:187-98.

29. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pireli SA, et al. Histiocytic sarcoma. En: WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC: Lyon 2008, pp: 356-357.