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Abnormal Proliferation

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Under normal conditions, most adult cells remain in a non-proliferative state unless stimulated by internal or external factors to replace lost cells. Abnormal cell proliferation is a condition in which the cell's growth exceeds and is uncoordinated with normal cells. In such situations, cell division persists in the same excessive manner even after cessation of the stimuli, leading to persistent tumors. The tumor arises from the damaged cells that replicate to pass the damage to the daughter...

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Diffuse Large B-Cell Lymphoma Transdifferentiating Into Histiocytic Sarcoma: Case Report + Systematic Review.

Patricia K Mansfield¹, Sino Mehrmal², M Yadira Hurley^3,4

¹Saint Louis University School of Medicine, Saint Louis University, St. Louis, Missouri, USA.

Journal of Cutaneous Pathology

|December 26, 2025

Summary

This summary is machine-generated.

This study reports the first case of cutaneous histiocytic sarcoma (HS) in a patient with diffuse large B-cell lymphoma (DLBCL), linked by identical KRAS mutations. The findings suggest a rare transdifferentiation event from DLBCL to HS.

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Enhancing Tumor Content through Tumor Macrodissection

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Area of Science:

Hematology
Oncology
Pathology

Background:

Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma.
Cutaneous involvement in DLBCL can manifest as various skin lesions.
Histiocytic sarcoma (HS) is a rare malignancy of myeloid or histiocytic origin.

Purpose of the Study:

To report a unique case of cutaneous histiocytic sarcoma (HS) arising in a patient with a history of diffuse large B-cell lymphoma (DLBCL).
To investigate the potential link between DLBCL and HS through genetic analysis.
To review existing literature on cutaneous HS with underlying hematologic malignancies.

Main Methods:

Clinical presentation and histopathologic examination of a patient with a rapidly growing skin tumor.
Immunophenotypic characterization of tumor cells.
Genetic analysis (KRAS mutation detection) of DLBCL and HS specimens.
Systematic literature review of cutaneous HS cases.

Main Results:

Histopathology confirmed cutaneous histiocytic sarcoma (HS) in a patient with prior diffuse large B-cell lymphoma (DLBCL).
Identical p.G13D KRAS mutations were found in both the DLBCL and HS specimens, suggesting a common origin.
Literature review identified only two prior cases of cutaneous HS with underlying hematologic transdifferentiation.

Conclusions:

This case represents the first documented instance of systemic DLBCL with cutaneous involvement transdifferentiating into cutaneous HS, supported by identical KRAS mutations.
The findings highlight a rare phenomenon of histiocytic transdifferentiation in the context of hematologic malignancy.
Distinct clinical and pathological features underscore the unique nature of this case.