J Breast Cancer.  2019 Sep;22(3):491-496. 10.4048/jbc.2019.22.e32.

Primary Histiocytic Sarcoma Presenting as a Breast Mass: A Case Report

• Bang S
• Kim Y
• Chung MS
• Park JS
• Choi YY
• Shin SJ

• KMID: 2458869
• DOI: http://doi.org/10.4048/jbc.2019.22.e32

Abstract

Histiocytic sarcoma is a rare hematologic malignancy, with very few cases of primary histiocytic sarcoma of the breast described in English scientific literature. Herein, we describe a case of primary histiocytic sarcoma of the breast in a 75-year-old woman, with no clinical history of malignant tumors, who presented with a palpable solitary breast mass. Microscopically, the resected breast mass showed large pleomorphic cells, some multinucleated giant cells, and admixed inflammatory components. The pleomorphic tumor cells further showed a diffuse, noncohesive growth pattern, an abundant eosinophilic cytoplasm, and strong and diffuse immunoreactivity for cluster of differentiation (CD) 68 and CD163. Furthermore, a whole-body positron-emission tomography/computed tomography using deoxy-2-[¹â¸F]fluoro-D-glucose performed after surgery showed no other masses or lesions. After surgical excision, the patient was followed up, and no evidence of tumor recurrence or metastasis was noted.

Keyword

Breast; Histiocytes; Histiocytic sarcoma; True histiocytic lymphoma

MeSH Terms

Aged
Breast*
Cytoplasm
Eosinophils
Female
Giant Cells
Hematologic Neoplasms
Histiocytes
Histiocytic Sarcoma*
Humans
Neoplasm Metastasis
Recurrence

Figure

• 

  Figure 1 Breast ultrasonography shows a microlobulated hypoechoic mass in the right breast.

• 

  Figure 2 Histopathologic features of the histiocytic sarcoma. (A) The round solid mass is approximately 1.5 cm × 1.2 cm in size and is surrounded by breast tissue. (B) In the scanning view, the tumor is well-demarcated and shows high cellularity. (C) The tumor cells show a diffuse, noncohesive growth pattern and various admixed inflammatory components are also identified (hematoxylin-eosin stain, original magnification ×100). (D) Large atypical cells with an abundant eosinophilic cytoplasm as well as multinucleated giant cells are frequently observed. Mitosis is also easily observed. (hematoxylin-eosin stain, original magnification ×400).

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  Figure 3 Results of the immunohistochemistry (original magnification ×400). The tumor cells show strong and diffuse immunoreactivity for CD68 (A) and CD163 (B), and are negative for CD21 (C) and CD1a (D). CD = cluster of differentiation.

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