J Nephropathol. 2015;4(3):97-100.
doi: 10.12860/jnp.2015.18
PMID: 26312238
PMCID: PMC4544561
Scopus id: 84936936996
  Abstract View: 1515
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Case Report

Histiocytic sarcoma; case report of a rare disease in a kidney transplant recipient

Pedro Ventura Aguiar 1 * , Carla Dias 2, Pedro Azevedo 1, Hugo Neves Silva 1, Manuela Almeida 1, Sofia Pedroso 1, La Salete Martins 1, Leonídio Dias 1, Anabela Rodrigues 1, Ramón Viscaíño 2, António Cabrita 1, António Castro Henriques 1

1 Renal Transplant Unit, Nephrology Department, Centro Hospitalar do Porto, Portugal
2 Department of Pathology, Centro Hospitalar do Porto, Portugal
*Corresponding author: Pedro Ventura Aguiar, Nephrology department - Centro Hospitalar do Porto, Largo Professor Abel Salazar, Porto, Portugal. Email: pedro.ventura.aguiar@gmail.com


Background: Histiocytic sarcoma (HS) is a rare hematologic neoplasm with a few hundred cases having been described to date.

Case Presentation: We report the case of a 56-year-old woman with a history of hepatitis C infection and chronic kidney disease (CKD), submitted to a kidney transplant in 1984, under maintenance immunosuppression with prednisone and azathioprine. Patient presented with a relentlessly growing mass on her right front thorax. It was painless, smooth, and adherent to the deep muscle. Laboratory studies were unremarkable. Ultrasonography and computerized tomography (CT) scan revealed a highly vascularized heterogeneous mass (8×9 cm), with a necrotic centre. Positron emission tomography (PET) scan demonstrated multiple thoracic, abdominal, and pelvic nodules. Histology revealed a highly undifferentiated HS (vimentin, CD68, CD99, and CD4 positive). In spite of having started treatment with etoposide and thalidomide, no clinical response was achieved and the patient died three months later.

Conclusions: To the authors’ knowledge, this is the first described case of HS in a solid organ transplant patient.

Implication for health policy/practice/research/medical education:

A World Health Organization (WHO) expert panel stated histiocytic sarcoma is likely to be underdiagnosed. The case herein presented provides evidence to the existence of this rare disease in solid organ transplant recipients. Therefore this diagnosis should be considered in the presence of an undifferentiated sarcoma (vimentin and CD68 positive). Moreover, the presented case highlights the importance of positron emission tomography (PET) scan for the diagnosis of disseminated disease.

Please cite this paper as: Ventura Aguiar P, Dias C, Azevedo P, Silva HN, Almeida M, Pedroso S, et al. Histiocytic sarcoma: case report of a rare disease in a kidney transplant recipient. J Nephropathol. 2015;4(3):97-100. DOI: 10.12860/jnp.2015.18

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