Histiocytic Sarcoma of the Bile Duct

Abstract

An 80-year-old man was admitted with anorexia, a high fever and general icterus. Laboratory examinations revealed remarkable inflammation and elevation of liver/biliary enzymes. Computed tomography (CT) showed a high-density lesion in the bile duct, and endoscopic retrograde cholangiopancreatography (ERCP) disclosed an oval filling defect mimicking choledocholithiasis. Plastic stents were inserted to treat the acute cholangitis; however, the patient's symptoms recurred. An erythematous hypervascular mass obtained with a balloon catheter contained numerous pleomorphic histiocytic cells with eosinophilic cytoplasm, remarkable anisonucleosis and occasional mitoses. A diagnosis of histiocytic sarcoma (HS) was made based on the results of intensive immunohistochemistry. Monoclonal rearrangement of the IGH and TCRG genes, IGH split and IGH/BCL2 fusion was negative, although polysomy 8, 14, and 18 was detected. The patient was treated conservatively and died of the disease 20 months after the initial diagnosis. To the best of our knowledge, this is the first case of bile duct HS. This case, which involved numerical alterations of chromosomes, presented with CT and ERCP findings similar to those of choledocholithiasis.

The Non-Langerhans Cell Histiocytoses (Rare Histiocytoses) – Clinical Aspects and Therapeutic Approaches

“…Less often, primary lung disease resembling pulmonary LCH [196], and primary parotid gland involvement have been described [6]. The disease may spread to other organs, i. e. lungs, liver, spleen [20], bile ducts [141], and CNS; in the latter, both intracerebral lesions [46,80,164] and lesions in the spinal cord have been described [161]. Also, leukemia-like spread of cells in the blood may occur [36].…”

Leukemic Phase of Histiocytic Sarcoma of the Digestive System: A Rare Manifestation of a Rare Disease

“…Presentation of abdominal pain, dysphagia, weight lost, nausea, vomiting, diarrhea, small bowel obstruction, and GI bleeding have all been reported. Involvement of the gallbladder and bile duct – as in our case – are extremely rare and have just recently been reported [18]. The appearance of circulating histiocytes in the peripheral blood of our patient as part of disease progression (“leukemic phase”) is extremely rare.…”

Fine‐needle aspiration findings of a rare hematopoietic neoplasm presenting as obstructive jaundice

“…14 of those cases involved the luminal gastrointestinal tract including the stomach, small intestine, large intestine, and anus. The one additional case involved a common bile duct mass mimicking choledococholelitiasis . Since this review article, one additional case study has reported histiocytic sarcoma of the espophagus and 2 additional cases were reported in the stomach .…”