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Yang et al.                                                                                                                                                           Aggressive primary hepatic histiocytic sarcoma

           receptor beta, and  IGH genes may be seen and do   approval by Institutional Review Board at Loma Linda
           not exclude the diagnosis of HS. However, when HS   University Medical Center.
           is associated with lymphoma, identical  clonal gene
           rearrangements may be present. [13]                REFERENCES

           HS most commonly presents at an advanced clinical   1.   Takahashi E, Nakamura S. Histiocytic sarcoma: an updated literature
           stage, with poor response to chemotherapy and a high   review based on the 2008 WHO classification. J Clin Exp Hematop
           mortality rate. Although some patients may respond to   2013;53:1-8.
           chemotherapy with or without radiotherapy, the majority   2.   Hornick JL, Jaffe ES, Fletcher CD. Extranodal histi ocytic sarcoma:
           of the patients die of progressive disease within two   clinicopathologic analysis of 14 cases of a rare epithelioid malignancy.
           years. Important prognostic  factors include  stage at   3.   Am J Surg Pathol 2004;28:1133-44.
                                                                 Mounajjed  T, Chandan  VS, Torbenson MS, editors.  Surgical
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                                                                 histiocytosis,  Rosai-Dorfman  disease  and splenic  lymphoma  with
           In conclusion, we present a rare case of primary hepatic   fatal outcome after rapid development of histiocytic sarcoma of the
           HS. The diagnosis is challenging, and requires a high   liver. J Cutan Pathol 2012;39:1125-30.
           index of suspicion.  The diagnosis  should be based   5.   Rubtsova NA, Sidorov DV, Petrov LO, Zhukov NV, Vernyuk MA,
           on a combination of compatible histomorphology and    Pavlova OA. Diagnosis and treatment of primary sarcoma of the liver
           positivity  for  histiocyte-specific  markers,  and  also   6.   (case review). Radiology 2014;1:43.
                                                                 Chun HJ, Kee KH, Suh CH, Lim SC, Song HS. Primary malignant
           requires exclusion of  more common neoplasms by       lymphoma of true histiocytic origin of the liver: histiocytic sarcoma,
           extensive immunophenotypic studies.                   kupffer cell sarcoma: a case report with immunohistochemical and
                                                                 ultrastructural studies. Korean J Pathol 1989;23:165-80.
           Acknowledgments                                    7.   Swerdllow SH, Campo E, Harris NL. WHO classification of tumours
           The  authors thank Mary  Dennis and Maria Rabina      of haematopoietic and lymphoid tissues. France: IARC Press; 2008. p.
           (MHS PA) for assistance  in specimen  grossing,  and   356-7.
           Michael Mitchell for assistance in autopsy.        8.   Mathé G, Gerard-Marchant  R, Texier  JL, Schlumberger  JR,
                                                                 Berumen  L, Paintrand  M. The two varieties  of lymphoid  tissue
                                                                 “reticulosarcomas”, histiocytic and histioblastic types. Br J Cancer
           Financial support and sponsorship                     1970;24:687-95.
           None.                                              9.   Pakravan A, Bhatia R, Oshima K, Chen G, Fesler M, Prather C, Taylor
                                                                 JR. Histiocytic sarcoma: the first reported case of primary esophageal
           Conflicts of interest                                 involvement. Am J Gastroenterol 2014;109:291-2.
           There are no conflicts of interest.                10.  Dalia S, Shao H, Sagatys E, Cualing H, Sokol L. Dendritic cell and
                                                                 histiocytic  neoplasms:  biology, diagnosis, and treatment.  Cancer
                                                                 Control 2014;21:290-300.
           Patient consent                                    11.  Ohnishi K, Tanaka S, Oghiso Y, Takeya M. Immunohistochemical
           The patient's parent(s) signed consents and documents   detection of possible cellular origin of hepatic histiocytic sarcoma in
                                                                 mice. J Clin Exp Hematop 2012;52:171-7.
           are available for review upon request.             12.  Lindberg MR. Diagnostic Pathology: Soft Tissue Tumors. Elsevier
                                                                 Health Sciences; 2015. p. 310-1.
           Ethics approval                                    13.  Vasef MA, Auerbach A. Diagnostic Pathology: Molecular Oncology.
           Case report is waived and does not require further    Elsevier Health Sciences; 2016. p. 2-4.






















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