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Published on: September 1, 2018
Histiocytic sarcoma of the brain
Spinderjeet Gill-Samra1, Thomas Ng, Mark Dexter
1Department of Tissue Pathology, Level 3, ICPMR, Westmead Hospital, Hawkesbury Rd, Westmead, New South Wales 2145, Australia. sgill379@yahoo.co.in
Summary
This study reports a rare case of primary histiocytic sarcoma affecting only the central nervous system (CNS). The brain lesions contained unique neoplastic cells with lysosome-rich cytoplasmic globules.
Area of Science:
- Oncology
- Neuropathology
- Hematopathology
Background:
- Histiocytic sarcoma is a rare lymphoid malignancy typically affecting extranodal sites.
- Primary central nervous system (CNS) involvement is exceptionally uncommon.
Observation:
- A 36-year-old woman presented with multifocal CNS lesions.
- Histopathological analysis revealed pleomorphic histiocytes positive for CD45, CD68, and CD163.
- Neoplastic cells uniquely contained eosinophilic, CD68-positive cytoplasmic globules, identified as lysosomes via electron microscopy.
Findings:
- Extensive staging investigations excluded systemic or other primary disease.
- The diagnosis of primary CNS histiocytic sarcoma was confirmed.
- Immunohistochemistry ruled out lymphoma, melanoma, germ cell tumors, and other primary brain tumors.
Implications:
- This case expands the known clinical spectrum of histiocytic sarcoma.
- Highlights the importance of considering rare differentials in CNS neoplasms.
- The unique cellular morphology may aid in future diagnoses.
