Abstract:
In this review, we discuss a logical approach to diagnosis of histiocytic and dendritic cell lesions of the mediastinum. We break down the differential diagnosis between true neoplasms of histiocytic and dendritic cells [Rosai-Dorfman disease (RDD), Langerhans cell histiocytosis (LCH), and follicular dendritic cell sarcoma (FDCS)] versus selected neoplasms of other lineages which frequently attract non-neoplastic histiocytes or resemble them morphologically (carcinoma, melanoma, sarcoma, germinoma, mesothelioma, and lymphoma). As neoplasms in the latter category are more common, they should be stringently excluded before diagnosing a lesion in the first group, particularly given enormous differences in clinical management. We also consider histiocytic sarcoma (HS), an extremely rare lesion which, in some cases is likely of intrinsic histiocytic differentiation, whereas in others represents clonal evolution from an underlying non-histiocytic neoplasm.
摘要:
在这次审查中,我们讨论了诊断纵隔组织细胞和树突状细胞病变的逻辑方法。我们分解了组织细胞和树突状细胞的真正肿瘤之间的鉴别诊断[Rosai-Dorfman病(RDD),朗格汉斯细胞组织细胞增生症(LCH),和滤泡树突状细胞肉瘤(FDCS)]与其他谱系的选定肿瘤相比,这些肿瘤经常吸引非肿瘤组织细胞或在形态上与它们相似(癌,黑色素瘤,肉瘤,生殖细胞瘤,间皮瘤,和淋巴瘤)。由于后一类肿瘤更常见,在第一组诊断病变之前,应严格排除它们,特别是考虑到临床管理的巨大差异。我们还考虑组织细胞肉瘤(HS),一种极其罕见的病变,在某些情况下可能是固有的组织细胞分化,而在其他人中,代表从潜在的非组织细胞肿瘤的克隆进化。