Abstract：
BACKGROUND: Histiocytic sarcoma (HS) is a rare hematologic malignancy. HS of the breast is extremely rare, and we present a case of an elderly patient with breast HS.
METHODS: An 81-year-old woman with unremarkable past medical and family histories presented to our hospital with a palpable mass in her right upper breast. She had noticed a mass in her right breast 3 months before her first visit. Physical examination revealed a mass measuring approximately 30 mm in the right upper quadrant of the breast; there were no cervical or axillary lymphadenopathies. Mammography revealed a high-concentration mass with unclear margins in the upper and outer breast. Ultrasound and magnetic resonance imaging (MRI) revealed a 31 × 23-mm nodule with a relatively clear margin and necrotic sign on the T2-intensified image. A mastectomy was performed upon the patient\'s request, and the surgical specimen revealed a 35-mm hemorrhagic mass. The lesion was estrogen receptor-, progesterone receptor-, and HER2/neu-negative. The Ki-67 labeling index was approximately 30%. The immunohistochemical panel showed immune reactivity for the histiocytic markers CD68, CD163, and CD206 and was immune-negative for B lineage, T lineage, Langerhans cells, and keratins. The diagnosis of HS was based on the morphological and immunophenotypic characteristics of the mass. The patient received no systemic therapy and survived for 50 months without recurrence.
CONCLUSIONS: Here, we report the case of an elderly patient with rare breast HS. Although the prognosis of HS seems poor, the breast HS was not as poor as expected, since it might have been discovered in the local region before it metastasized.
METHODS: An 81-year-old woman with unremarkable past medical and family histories presented to our hospital with a palpable mass in her right upper breast. She had noticed a mass in her right breast 3 months before her first visit. Physical examination revealed a mass measuring approximately 30 mm in the right upper quadrant of the breast; there were no cervical or axillary lymphadenopathies. Mammography revealed a high-concentration mass with unclear margins in the upper and outer breast. Ultrasound and magnetic resonance imaging (MRI) revealed a 31 × 23-mm nodule with a relatively clear margin and necrotic sign on the T2-intensified image. A mastectomy was performed upon the patient\'s request, and the surgical specimen revealed a 35-mm hemorrhagic mass. The lesion was estrogen receptor-, progesterone receptor-, and HER2/neu-negative. The Ki-67 labeling index was approximately 30%. The immunohistochemical panel showed immune reactivity for the histiocytic markers CD68, CD163, and CD206 and was immune-negative for B lineage, T lineage, Langerhans cells, and keratins. The diagnosis of HS was based on the morphological and immunophenotypic characteristics of the mass. The patient received no systemic therapy and survived for 50 months without recurrence.
CONCLUSIONS: Here, we report the case of an elderly patient with rare breast HS. Although the prognosis of HS seems poor, the breast HS was not as poor as expected, since it might have been discovered in the local region before it metastasized.
摘要：
背景：组织细胞肉瘤（HS）是一种罕见的血液系统恶性肿瘤。乳房的HS极为罕见，我们介绍了一例患有乳腺HS的老年患者。
方法：一位81岁的女性，过去的病史和家族史并不明显，她的右上乳房有明显的肿块。在第一次访问前3个月，她注意到右乳房有肿块。体格检查显示，乳房右上腹有约30mm的肿块；没有宫颈或腋窝淋巴结病。乳房X线照相术显示高浓度肿块，上乳和外乳边缘不清。超声和磁共振成像（MRI）在T2增强图像上显示一个31×23毫米的结节，具有相对清晰的边缘和坏死征象。根据病人的要求进行了乳房切除术，手术标本显示有一个35毫米的出血性肿块。病变是雌激素受体，孕酮受体-,和HER2/neu阴性。Ki-67标记指数约为30%。免疫组织化学面板显示对组织细胞标记CD68，CD163和CD206的免疫反应性，对B谱系免疫阴性，T谱系，朗格汉斯细胞,和角蛋白.HS的诊断基于肿块的形态和免疫表型特征。患者未接受全身治疗，存活50个月无复发。
结论：这里，我们报告一例罕见乳腺HS的老年患者.尽管HS的预后似乎较差，乳房HS没有预期的那么差，因为它可能是在转移之前在当地发现的。
方法：一位81岁的女性，过去的病史和家族史并不明显，她的右上乳房有明显的肿块。
结论：这里，
