Concomitant follicular lymphoma and histiocytic sarcoma: A rare progression, trans-differentiation or co-occurrence.
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Date
2015-10
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Abstract
Trans‑differentiation of follicular lymphoma (FL) into a histiocytic sarcoma (HS) is
a rare event and usually occurs as a sequential event. We report a case where in
the same node with two distinct areas one of low‑grade FL and another with HS
was observed. This patient was a 58 years old with generalized lymphadenopathy
and Ann Arbor Stage III disease. The cervical node biopsy on histological
examination revealed two distinct areas, firstly a FL with nodular architecture
and the other a smaller focus of sheets of pleomorphic histiocytic cells diffusely
arranged at the edge of the section contiguous with FL with few cells in transiting
phase. On immunohistochemistry the FL was positive for CD20, CD10, PU.1,
PAX5 and Bcl2, while the large histiocytic cells were positive for CD163, CD68,
LCA, and PU.1, weakly for PAX5 and negative for CD20, CD10, CD30, CD3,
CD1a, Bcl2, S100, and Alk‑1. The therapeutic implications of this diagnosis and
postulated theories on trans‑differentiation are discussed.
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Keywords
Follicular lymphoma, histiocytic sarcoma, trans‑differentiation
Citation
Verma Anuj, Shet Tanuja. Concomitant follicular lymphoma and histiocytic sarcoma: A rare progression, trans-differentiation or co-occurrence. Indian Journal of Pathology & Microbiology. 2015 Oct-Dec 58(4): 537-539.