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PubMed1982

Acute myelomonocytic leukemia presenting as a primary cutaneous lymphoma of true histiocytes.

Malignant histiocytic and monocytic infiltrates of the skin are seen in true histiocytic lymphomas, in malignant histiocytosis, and in monocytic leukemias. Occasionally such cutaneous lesions constitute the presenting manifestation of the underlying malignancy. We report here a patient whose first manifestation of acute myelomonocytic leukemia was a malignant histiocytic infiltrate in the skin. Cytochemical and electron microscopic data confirmed the histiocytic nature of the skin tumor, and cytochemical data documented the myelomonocytic nature of the subsequent leukemia. Purely histiocytic skin tumors do not often presage myelomonocytic leukemias, although they have developed into monocytic leukemias, and monocytic leukemias have been transformed into myelomonocytic leukemias.

Aged↗

PubMedDate not supplied

Histiocytic disorders with spontaneous regression in infancy.

The histiocytic disorders are uncommon, have a wide spectrum, and are poorly understood. We describe seven cases developing in infancy, seen during a period of 9 years at Asan Medical Center, Seoul, Korea. Clinically the patients had multiple papules over the face, trunk, and extremities that developed at birth or during infancy. Histopathologic examinations revealed an infiltrate of many histiocytic cells in the upper dermis with or without epidermotropism. Four cases were classified as congenital self-healing reticulohistiocytosis in that the histiocytes were identified as Langerhans cells by positive immunohistochemical staining for S-100 protein, ultrastructural studies showing many Birbeck granules, and spontaneous regression of the lesions within 1-4 months. One infant with a solitary lesion on the forehead was diagnosed as solitary, congenital, indeterminate cell histiocytoma because the histiocytic cells were S-100 protein positive, but meticulous ultrastructural studies did not detect Birbeck granules. The lesion was removed by shave excision. Two cases were classified as generalized eruptive histiocytoma. The histiocytic cells were S-100 protein negative and ultrastructurally Birbeck granules were absent. In one patient, eyeball- or popcornlike lysosomal structures were seen. The lesions regressed completely.

Diagnosis, Differential↗

PubMed1993

Histiocytic reaction associated with topical aluminum chloride (Drysol reaction)

BACKGROUND: In the past few years, dermatologists have begun to use aluminum chloride (Drysol) as a hemostatic agent for minor surgical procedures. An unusual histiocytic reaction was noted in biopsies of skin previously treated with aluminum chloride. This reaction consisted of a proliferation of histiocytic cells that contained prominent basophilic cytoplasmic granules. OBJECTIVE: To determine the cause of this reaction and the nature of the basophilic granular material within the histiocytic cells. METHODS: Four cases are presented in which re-excised tissue previously treated with aluminum chloride were examined with special histochemistry staining and roentgen diffraction studies. RESULTS: The granules of these histiocytes stained positively with the aluminon stain, a stain specific for aluminum, although no aluminum was found using the less sensitive roentgen diffraction studies. CONCLUSION: These studies support the concept that aluminum chloride can cause a proliferative histiocytic reaction when used as a topical cauterizing agent.

Administration, Cutaneous↗

PubMedDate not supplied

Sonographic features of histiocytic neoplasms in the canine abdomen.

The purpose of this retrospective study was to describe the ultrasonographic features of malignant histiocytosis (MH), malignant fibrous histiocytoma, and histiocytic sarcoma in abdominal organs of dogs. The medical records of 18 dogs that had undergone abdominal sonography and had a histopathologic diagnosis of abdominal MH, malignant fibrous histiocytoma, and histiocytic sarcoma were reviewed. The organ most commonly affected was the spleen. MH was the most common followed by histiocytic sarcoma and malignant fibrous histiocytoma. In the spleen there were often multiple hypoechoic nodules with well-defined borders. In one dog, without focal lesions, the spleen was enlarged and hypoechoic. The liver was the second most commonly affected organ. MH was most common followed by histiocytic sarcomas and malignant fibrous histiocytoma. The most common sonographic feature in the liver was the presence of multiple hypoechoic nodules with well-defined borders. One dog without hepatic nodules had a liver that was ultrasonographically enlarged and hypoechoic. MH in the abdominal lymph nodes resulted in hypoechoic lymphadenopathy. Malignant fibrous histiocytoma was the only neoplastic type in the kidneys appearing as a single heteroechoic renal mass with well-defined borders. MH was observed in the stomach of one dog. Sonographically there was a single well circumscribed hypoechoic mass with well-defined borders and abnormal stomach layers. In this study it was not possible to differentiate between MH, malignant fibrous histiocytoma, and histiocytic sarcoma using sonography.

Abdominal Neoplasms↗

PubMed1991

Hyaline droplet accumulation in rodent kidney proximal tubules: an association with histiocytic sarcoma.

Since recognition during the last decade that certain renal carcinogens can initially cause an accumulation of hyaline (protein) droplets in proximal tubules of male rats, it has become appropriate to establish whether this phenomenon of protein overload can also occur in rodent kidneys unrelated to chemical treatment. Kidney tissue from a number of selected rodent studies held in the National Toxicology Program (NTP) or Food and Drug Administration (FDA) archives were evaluated for hyaline droplet accumulation in proximal tubules. The survey concentrated on rats and mice of both sexes bearing hematopoietic tumors, as our preliminary observations had suggested this direction of study. The tissues of 101 Sprague-Dawley, 25 Osborne-Mendel, and 70 Fischer 344 rats and 96 B6C3F1 mice were examined. These animals provided an assortment of tumors including histiocytic sarcoma, lymphocytic lymphoma, mononuclear cell leukemia, and sarcoma. Hyaline droplet accumulation, primarily involving the P2 segment of proximal tubules, was diagnosed in 96% of rats with histiocytic sarcoma (74/77 cases in Sprague-Dawley, 17/18 in Osborne-Mendels, 7/7 in Fischers) and in 55% of B6C3F1 mice with histiocytic sarcoma (18/33 cases). There appeared to be a qualitative correlation between hyaline droplet accumulation and degree of tumor burden. Thus, in cases negative for hyaline droplets, the tumor was often confined to a single location, while increasing involvement of proximal segments beyond P2 occurred with more extensive multi-organ dissemination of the tumor. By immunohistochemistry on 11 cases of rat and 8 cases of mouse histiocytic sarcoma, the protein in hyaline droplets was identified as lysozyme, a known major secretory product of monocytes and macrophages. The hyaline droplets were negative for alpha 1-antitrypsin, alpha 2u-globulin, rat or mouse immunoglobulin, and albumin. More sparsely scattered droplets and granules present in proximal tubules of Fischer rats with mononuclear cell leukemia were negative for lysozyme but positive for either iron or lipofuscin pigment. The study establishes a clear association between renal tubule hyaline droplet and lysozyme accumulation in rats and mice with histiocytic sarcoma. Hyaline droplets secondary to neoplasia should be distinguished from chemically-induced hyaline droplet nephropathy in the male rat involving alpha 2u-globulin.

Animals↗

PubMed1993

Amelanotic acral melanoma masquerading as fibrous histiocytic tumours. Three case reports.

We report 3 cases of amelanotic melanoma developing on the finger, whose histology disclosed dermal invasion of histiocyte-like tumour cells. One of the 3 cases was subungual melanoma and the other 2 were on the volar surface of the finger tip. Because of the characteristic dense infiltration of large histiocyte-like tumour cells, including many multinucleated giant cells, we initially considered histiocytic tumours. However, there were some histiocyte-like cells that displayed inclusion-like intranuclear invagination of cytoplasm, and almost all tumour cells, including the giant cells, were positive for S-100 protein. In addition, ultrastructural demonstration of premelanosomes within the cytoplasm of the tumour cells established the diagnosis of amelanotic melanoma. These features were distinct histologically from other variants of vertical growth phase amelanotic malignant melanoma, including desmoplastic or neurotropic melanoma. Because we encountered cases 2 and 3 within just a year after the first case, we think that the misdiagnosis of amelanotic "histiocytic" melanoma can be avoided through enhanced clinical awareness and subsequent appropriate histopathologic studies.

Aged↗

PubMed1984

Histiocytic malignancies. Morphologic, immunologic, and enzymatic heterogeneity.

We have studied 14 hematopoietic malignancies with histologic features of histiocytic differentiation, using frozen section immunologic stains, plastic section enzyme histochemistry, and paraffin section immunocytochemistry. There was morphologic, immunologic, and enzymatic heterogeneity, including findings in seven cases that suggested differentiation toward specialized subsets of histiocytes. Four cases expressed a mature monocyte/macrophage phenotype by frozen section monoclonal antibody staining and three of these had histologic patterns diagnostic of malignant histiocytosis; two other cases had ATPase and S100 protein reactivity and morphologic features consistent with interdigitating (reticulum) cell proliferations; and one case was alkaline phosphatase positive, suggestive of differentiation toward fibroblastic reticulum cells. Four cases had histologic findings consistent with malignant histiocytosis, but weak or unreactive staining patterns and were considered poorly differentiated histiocytic or primitive hematopoietic malignancies. Three other cases, also morphologically consistent with malignant histiocytosis, were identified as probably T-cell lymphomas. The morphologic and phenotypic characteristics of non-neoplastic histiocytes and dendritic cell types and their related neoplasms are discussed. Histiocytic malignancies comprise a diverse group that can be identified and subclassified by immunologic and enzymatic techniques.

Adolescent↗

PubMed1982

[Radiological aspects of malignant histiocytic pathology].

The histiocyte, macrophage of tissue monocyte is a cell of the mononuclear system. At the moment several different types of classification of the malignant histiocytic pathology are use. Seven cases of this pathology are documented: two cases of malignant histiocytosis, two cases of malignant histiocytic lymphoma, two cases of malignant histiocytoma of soft tissue and one malignant histiocytic tumor of bone. The purpose of this study is to analyse the usefulness the roentgenologic methods: conventional radiography, radionuclide scanning, computed tomography, sonography, xeroradiography, angiography. The evaluation of malignant histiocytic pathology has become more precise through the introduction of ultrasonography and computed tomography. This report adds to the understanding of the entities of this pathology in that the diagnosis of malignance was made using roentgenologic criteria and confirmed by histology.

Adult↗

PubMedDate not supplied

A low incidence of histiocytic sarcomatosis associated with infection of chickens with the HPRS-103 strain of subgroup J avian leukosis virus.

Ten cases of histiocytic proliferative lesions in meat-type chickens associated in low incidence with infection by subgroup J avian leukosis virus (ALV) are described. Six were field cases in adult chickens from naturally infected flocks and four were from younger birds from transmission experiments with HPRS-103 ALV or the related acutely transforming ALV strains 17 and 879. The lesions were observed mostly in the spleen and in some cases in other organs. Microscopically, the lesions were comprised mainly of pleomorphic histiocyte-like cells admixed with variable numbers of lymphoid cells. More detailed studies were carried out on two birds at 4 and 7 wk of age following infection with HPRS-103 at 1 day of age. These birds had multiple small nodular lesions in the spleen, liver, and kidney that appeared similar cytologically to the more extensive lesions in older birds. Monoclonal antibodies specific for various lymphoid and nonlymphoid accessory cells were used in immunohistochemical studies to identify a predominance of cells of monocyte/macrophage lineage, and CD4- and CD8-positive lymphocytes, in the splenic nodules. Ultrastructural studies also revealed a similar mixed population of cells. Expression of ALV group-specific antigen, and gag and ALV-J env RNA, was not a marked feature of the histiocytic lesions. The proliferative histiocytic lesion is designated a histiocytic sarcomatosis.

Animals↗

PubMed1991

Histiocytic neoplasias: immunohistochemical evaluation of their frequencies among malignant lymphoma and related conditions in Japan.

Through histologic review of 1,766 cases with malignant lymphoma and related conditions, 35 cases (2%) were selected as probable histiocytic neoplasias. Proliferating cells in these cases had voluminous, granulated cytoplasm, and round to irregularly shaped nuclei often with bi- or multinucleated forms showing monomorphous or polymorphous proliferation accompanying small lymphocytes, plasma cells, and, less frequently, eosinophils. Cases showing proliferation of convoluted cells with numerous benign-appearing histiocytes or large cells with clear cytoplasm were excluded under a diagnosis of T-cell lymphoma. To evaluate the immunologic character of proliferating cells, immunohistochemistry using antibodies Mx-Pan B, MB-1, MT-1, UCHL-1, lysozyme, alpha 1-antitrypsin, alpha 1-antichymotrypsin, S-100 alpha, S-100 beta, Leu M1, epithelial membrane antigen, and Ki-1 were carried out in 23 cases. Naphthol-ASD-chloracetate reaction and toluidine blue stain were also performed. These procedures revealed that 12 cases (52%) were B-cell type, three cases (13%) T-cell type, six cases (26%) true histiocytic type, and two cases null type. Therefore, the frequency of cases with true histiocytic neoplasias among cases with malignant lymphoma and related conditions in Japan may be 0.5%.

Antibodies, Monoclonal↗

PubMed1964

STUDIES OF TUBERCLE BACILLUS-HISTIOCYTE RELATIONSHIPS. 8. COMPARATIVE STUDY OF CELLULAR RESISTANCE INDUCED BY BRUCELLA AND MYCOBACTERIA.

Comparison of the Brucella-immune and the BCG-immune histiocyte, each of which is resistant to necrotization by either Brucella or mycobacteria, has revealed a number of dissimilarities in their behavior. The Brucella-immune histiocyte was found to be incapable of transferring its resistance to the cells of normal animals; it was also unable to achieve attenuation of virulent tubercle bacilli. In contrast, the BCG-immune histiocyte and certain of its subcellular components (ribosomes and ribosomal RNA) were effective in inducing cellular resistance in normal animals against both Brucella and mycobacteria. When RNA was used, only immune ribosomal RNA was effective; when intact ribosomes were used, both immune and recipient ribosomes proved active. These investigations have also shown that the resistance of the BCG-immune histiocyte against Brucella and mycobacteria was of long duration and not readily dissociable.

Animals↗

PubMedDate not supplied

Lipidosis with sea-blue histiocytes. Report of two siblings with lung involvement.

Two siblings, an eight-year-old girl and a three-year-old boy with lipid storage disease, most likely non-neuropathic Niemann-Pick disease (NPD) with sea-blue histiocytes, are presented. Both of them had foamy and sea-blue histiocytes in their bone marrow smears and reticulo-nodular appearance of both lungs on their chest X-rays. Case 1 had diffuse, biopsy-proven, pulmonary involvement associated with sea-blue histiocytes. Although diffuse reticulo-nodular pulmonary infiltration of non-neuropathic NPD (type B) is frequently detected on chest X-rays, to our knowledge there is only one reported adult case of lipidosis resembling NPD in which severe pulmonary involvement associated with pigmented histiocytes and Niemann-Pick cells were demonstrated at autopsy.

Bone Marrow↗

PubMed1998

Clinical significance of histiocytes in the detection of endometrial adenocarcinoma and hyperplasia.

The purpose of this case-control study was to determine the clinical significance of histiocytes and normal endometrial cells as cytologic markers of adenocarcinoma or hyperplasia of the endometrium. Cervical-vaginal smears obtained in 102 patients with mean age 59.7 yr with abnormal uterine bleeding and endometrial pathology, and 101 controls with mean age 56.5 yr with postmenopausal bleeding and whose cytologic smear was negative, were evaluated. Histiocytes alone failed to predict either endometrial adenocarcinoma (odds ratio [OR], 1.02; 95% confidence interval [CI], 0.32-3.22) or hyperplasia (OR, 1.10; 95% CI, 0.37-3.30). The odds of endometrial carcinoma in symptomatic, postmenopausal women was three times greater in the presence of histiocytes with phagocytosis of acute inflammatory cells (PIC) (OR, 3.00; 95% CI, 1.16-7.70). Endometrial hyperplasia was more frequently observed when cervical smears contained normal endometrial cells (OR, 4.09; 95% CI, 1.14-14.67). Only histiocytes with PIC and normal endometrial cells carry a three- and fourfold greater likelihood of coexistent endometrial adenocarcinoma and hyperplasia, respectively. Such strong association may require endometrial biopsy or transvaginal ultrasonography to uncover lesional tissue in the endometrial cavity.

Adenocarcinoma↗

PubMed1999

Histiocyte reaction in rabbit femurs to UHMWPE, metal, and ceramic particles in different sizes.

To assess the histologic reaction caused by biomaterial particles in different sizes around the bone-implant interface, we examined ultra-high molecular weight polyethylene (UHMWPE, average diameter of 11 microm), UHMWPE (99 microm), cobalt-chromium alloy (Co-Cr, 3.9 microm), stainless steel (SUS316L, 3.9 microm), alumina ceramics (3.9 microm), titanium alloy (Ti, 3.5 microm), Co-Cr (0.03 microm), and Ti (0.03 microm). After the longitudinal groove on a polymethylmethacrylate plug was filled with one type of the particles, the plug was inserted into the medullar canal of the distal end of rabbit femurs, and tissue block was resected 4 and 12 weeks after the insertion. Histiocytes were markedly accumulated around the particles of UHMWPE (11 microm), Co-Cr (3.9 microm), SUS316L (3.9 microm), Co-Cr (0.03 microm), and titanium alloy (0.03 microm). Around the UHMWPE particles (99 microm), a slight histiocytic reaction and bone formation were observed. Particles of alumina ceramics (3.9 microm) and titanium alloy (3.5 microm) which were in phagocytosable sizes also had few histiocytic reactions. Statistically, the material difference was more strongly related to the histiocyte reaction than to the particle size and calculated total surface area of particles. Our findings demonstrate that particles of different biomaterials and in different sizes induce different foreign-body histological reactions.

Aluminum Oxide↗

PubMed1986

Histiocytes in nasopharyngeal carcinoma in relation to prognosis.

Forty-nine biopsy specimens of nasopharyngeal carcinoma and 20 biopsy specimens of nasopharyngeal mucosa obtained from non-cancer patients were studied for the presence of T-zone histiocytes (Langerhans' cells and their precursors) and macrophages by immunohistochemical methods with the use of antibodies against S-100 protein and lysozyme (lys), respectively. Patients with dense infiltration of T-zone histiocytes in the primary sites survived longer than those without such infiltration (mean survival times, 8, 39, and 72 months in the patients with the density of -, +, and ++, respectively; P less than 0.005). In contrast, there was no relationship between patient prognosis and density of lys+ macrophages in the tumor tissue (P = 0.33). The distribution of T-zone histiocytes in the tumor tissue was different from that of macrophages. T-zone histiocytes may play an important role in the immune reaction against cancer, probably acting through mechanism different from that of macrophages.

Adolescent↗

PubMed1994

Dermatofibroma: superficial fibrous proliferation with reactive histiocytes. A multiple immunostaining analysis.

BACKGROUND: Dermatofibroma (DF) is a superficial form of benign fibrous histiocytoma, composed of a mixture of fibroblastic cells and histiocytic cells. The histogenesis of this lesion is a matter of controversy. METHODS: Forty-five cases of DF were investigated by single and multiple immunostaining techniques, using panel of 12 antibodies including proliferating cell nuclear antigen (PCNA), vimentin, and macrophage/histiocyte markers (HAM56 and CD68). RESULTS: Double immunostaining demonstrated that 58% of the DF cells simultaneously expressed PCNA and vimentin, whereas only 5% were PCNA+/HAM56+, and 2% were PCNA+/CD68+. By triple-stain for PCNA, vimentin, and HAM56, 56% of the DF cells were PCNA+/vimentin+/HAM56-, but only a few cells were PCNA+/HAM56+/vimentin+/-. Of the PCNA positive cells, 88% were vimentin+HAM56- and 10% were HAM56+ vimentin-/+. The cells positive for CD68 showed similar distribution to that of HAM56+ cells, though there were fewer of the former than the latter in most cases. These results suggest that the majority of the proliferating cells in DF express vimentin but not histiocytic markers. Morphologically, the PCNA+/vimentin+/HAM56- (or CD68-) cells exhibited a spindle-shaped configuration resembling fibroblasts, whereas most of the HAM56+/CD68+ cells possessed abundant rounded cytoplasm and were similar to normal histiocytes. CONCLUSIONS: The present study suggests that the proliferative compartment of DF cells is composed chiefly of mesenchymal/fibroblastic lineage, accompanied by varying numbers of normal reactive histiocytes.

Adolescent↗

PubMed1985

Adult Niemann-Pick disease masquerading as sea blue histiocyte syndrome: report of a case confirmed by lipid analysis and enzyme assays.

We present the clinical, pathologic, and metabolic findings of an adult woman with debilitating coronary artery disease and hepatosplenomegaly who was discovered to have multiorgan infiltration by sea blue histiocytes. A diagnosis of sea blue histiocyte (SBH) syndrome was made and no further workup performed. The patient suffered from progressive heart failure and sepsis following coronary artery bypass surgery and died 9 months after presentation. Tissues examined at autopsy showed pronounced infiltrates of both granular sea blue histiocytes and foamy, vacuolated histiocytes, which were morphologically compatible with Niemann-Pick cells. Ultrastructural examination of these cells revealed lamellar myelin-like figures as described in Niemann-Pick (N-P) disease. Fibroblast enzyme assay studies and liver lipid analyses performed after the patient's death revealed pronounced sphingomyelinase deficiency and a lipid profile diagnostic of N-P disease, type B. This case adds further support to the claim that some cases of apparent SBH syndrome actually represent a type of N-P disease.

Biopsy↗

PubMed2001

Significance of histiocytes in cervical smears from peri/postmenopausal women.

Histiocytes in cervicovaginal smears from peri- or postmenopausal women have been viewed as a potential indicator of endometrial neoplasia, but recent studies have refuted that view. This study further defines the clinical significance of such findings. All cervical smears were selected from women (< or = 50 yr) in whom the presence of histiocytes was mentioned; pertinent clinical history, follow-up information, and selected slides were reviewed. Among 105,225 total cervicovaginal smears from a 3.5-yr period, 106 smears from 103 women were identified. Forty-two patients (41%) were on hormone replacement therapy (2 on tamoxifen), and 23 (22.3%) patients experienced vaginal bleeding, all of whom had biopsy or cytology follow-up. Ten (9.6%) patients had no follow-up, 35 (32%) had repeat smears only, and 58 (56.3%) had endometrial/endocervical sampling. In 28 patients, the index smear was categorized as other than within normal limits or benign cellular changes; of these, 24 had subsequent tissue sampling and 4 had cytology follow-up. Of the patients with tissue sampling, 51 (84%) had benign findings (including polyps), 2 (3.5%) had hyperplasia, and 5 (10%) had adenocarcinoma. All 5 patients with adenocarcinoma had endometrial glandular cells on the smear, and 4 had vaginal bleeding. One patient with hyperplasia had vaginal bleeding, and the other was on tamoxifen and had endometrial glandular cells on the smear. None of the patients having only histiocytes on their smears and no clinical symptoms or risk factors had endometrial adenocarcinoma or hyperplasia. These findings support the conclusion that the presence of histiocytes alone on cervicovaginal smears from peri- or postmenopausal women is nonspecific and of no major clinical significance in the absence of other clinical or cytologic findings.

Aged↗