Skip to main content
Top
Published in: Forensic Science, Medicine and Pathology 4/2016

01-12-2016 | Case Report

Sudden unexpected death from an undiagnosed histiocytic sarcoma in an adolescent female

Authors: H. R. Haynes, Z. Melegh, S. Vanjani, M. Cieka, S. Beavers, N. Rooney, B. Purdue

Published in: Forensic Science, Medicine and Pathology | Issue 4/2016

Login to get access

Abstract

A previously well 15-year-old female who was awaiting medical investigations for a proptosed right eye collapsed and died suddenly while walking. Postmortem examination revealed diffuse distortion and infiltration of multiple organs by a suspected neoplastic process. Histology confirmed the invasion of multiple organs by atypical cells and myocardial infiltration was the likely cause of death. An extensive panel of immunohistochemistry established the diagnosis of a histiocytic sarcoma. Sudden unexpected death due to a clinically undiagnosed neoplasia in childhood and adolescence is uncommon. This is the first report of a histiocytic sarcoma causing sudden unexpected death and highlights the importance of considering undiagnosed hematological malignancies when examining a case of sudden death at postmortem.
Literature
1.
go back to reference Gilbert-Barness E, Debich-Spicer D. Handbook of paediatric autopsy pathology. New York City: Humana Press; 2005.CrossRef Gilbert-Barness E, Debich-Spicer D. Handbook of paediatric autopsy pathology. New York City: Humana Press; 2005.CrossRef
2.
go back to reference Gatter K, Delsol G, Warnke R, Pezzella F. Diagnosis of lymphoproliferative diseases. 2nd ed. Hoboken: Wiley-Blackwell; 2012. Gatter K, Delsol G, Warnke R, Pezzella F. Diagnosis of lymphoproliferative diseases. 2nd ed. Hoboken: Wiley-Blackwell; 2012.
3.
go back to reference Marafioti T, Paterson JC, Ballabio E, et al. Novel markers of normal and neoplastic human plasmacytoid dendritic cells. Blood. 2008;111:3778–92.CrossRefPubMed Marafioti T, Paterson JC, Ballabio E, et al. Novel markers of normal and neoplastic human plasmacytoid dendritic cells. Blood. 2008;111:3778–92.CrossRefPubMed
4.
go back to reference Dierksen J, Buja LM, Chen L. Clinicopathologic findings of hematological malignancy: a retrospective autopsy study. Ann Clin Lab Sci. 2015;45:565–73.PubMed Dierksen J, Buja LM, Chen L. Clinicopathologic findings of hematological malignancy: a retrospective autopsy study. Ann Clin Lab Sci. 2015;45:565–73.PubMed
5.
go back to reference Gowda RM, Khan IA. Clinical perspectives of primary cardiac lymphoma. Angiology. 2003;54:599–604.CrossRefPubMed Gowda RM, Khan IA. Clinical perspectives of primary cardiac lymphoma. Angiology. 2003;54:599–604.CrossRefPubMed
6.
go back to reference Somers GR, Smith CR, Perrin DG, et al. Sudden unexpected death in infancy and childhood due to undiagnosed neoplasia: an autopsy study. Am J Forensic Med Pathol. 2006;27:64–9.CrossRefPubMed Somers GR, Smith CR, Perrin DG, et al. Sudden unexpected death in infancy and childhood due to undiagnosed neoplasia: an autopsy study. Am J Forensic Med Pathol. 2006;27:64–9.CrossRefPubMed
7.
go back to reference Dearth JC, Fountain KS, Smithson WA, et al. Extreme leukemic leukocytosis (blast crisis) in childhood. Mayo Clin Proc. 1978;53:207–11.PubMed Dearth JC, Fountain KS, Smithson WA, et al. Extreme leukemic leukocytosis (blast crisis) in childhood. Mayo Clin Proc. 1978;53:207–11.PubMed
8.
go back to reference Bray RJ, Fernandes FJ. Mediastinal tumour causing airway obstruction in anaesthetised children. Anaesthesia. 1982;37:571–5.CrossRefPubMed Bray RJ, Fernandes FJ. Mediastinal tumour causing airway obstruction in anaesthetised children. Anaesthesia. 1982;37:571–5.CrossRefPubMed
9.
go back to reference Levin H, Bursztein S, Heifetz M. Cardiac arrest in a child with an anterior mediastinal mass. Anesth Analg. 1985;64:1129–30.CrossRefPubMed Levin H, Bursztein S, Heifetz M. Cardiac arrest in a child with an anterior mediastinal mass. Anesth Analg. 1985;64:1129–30.CrossRefPubMed
10.
go back to reference Hon K-E, Leung A, Chik K-W, et al. Critical airway obstruction, superior vena cava syndrome, and spontaneous cardiac arrest in a child with acute leukemia. Pediatr Emerg Care. 2005;21:844–6.CrossRefPubMed Hon K-E, Leung A, Chik K-W, et al. Critical airway obstruction, superior vena cava syndrome, and spontaneous cardiac arrest in a child with acute leukemia. Pediatr Emerg Care. 2005;21:844–6.CrossRefPubMed
11.
go back to reference Whybourne A, Zillman MA, Miliauskas J, et al. Sudden and unexpected infant death due to occult lymphoblastic leukaemia. J Clin Forensic Med. 2001;8:160–2.CrossRefPubMed Whybourne A, Zillman MA, Miliauskas J, et al. Sudden and unexpected infant death due to occult lymphoblastic leukaemia. J Clin Forensic Med. 2001;8:160–2.CrossRefPubMed
12.
go back to reference Maleszewski J, Lu J, Fox-Talbot K, et al. Robust immunohistochemical staining of several classes of proteins in tissues subjected to autolysis. J Histochem Cytochem. 2007;55:597–606.CrossRefPubMed Maleszewski J, Lu J, Fox-Talbot K, et al. Robust immunohistochemical staining of several classes of proteins in tissues subjected to autolysis. J Histochem Cytochem. 2007;55:597–606.CrossRefPubMed
13.
go back to reference Warnke R, Weiss L, Chan J, Cleary M, Dorfman R. Tumours of the lymph nodes and spleen. Washington, DC: Armed Forces Institute of Pathology; 1995. Warnke R, Weiss L, Chan J, Cleary M, Dorfman R. Tumours of the lymph nodes and spleen. Washington, DC: Armed Forces Institute of Pathology; 1995.
14.
go back to reference Ralfkiaer E, Delsol G, O’Connor NT, et al. Malignant lymphomas of true histiocytic origin. A clinical, histological, immunophenotypic and genotypic study. J Pathol. 1990;160:9–17.CrossRefPubMed Ralfkiaer E, Delsol G, O’Connor NT, et al. Malignant lymphomas of true histiocytic origin. A clinical, histological, immunophenotypic and genotypic study. J Pathol. 1990;160:9–17.CrossRefPubMed
15.
go back to reference Franchino C, Reich C, Distenfeld A, et al. A clinicopathologically distinctive primary splenic histiocytic neoplasm. Demonstration of its histiocyte derivation by immunophenotypic and molecular genetic analysis. Am J Surg Pathol. 1988;12:398–404.CrossRefPubMed Franchino C, Reich C, Distenfeld A, et al. A clinicopathologically distinctive primary splenic histiocytic neoplasm. Demonstration of its histiocyte derivation by immunophenotypic and molecular genetic analysis. Am J Surg Pathol. 1988;12:398–404.CrossRefPubMed
16.
go back to reference Kobayashi S, Kimura F, Hama Y, et al. Histiocytic sarcoma of the spleen: case report of asymptomatic onset of thrombocytopenia and complex imaging features. Int J Hematol. 2008;87:83–7.CrossRefPubMed Kobayashi S, Kimura F, Hama Y, et al. Histiocytic sarcoma of the spleen: case report of asymptomatic onset of thrombocytopenia and complex imaging features. Int J Hematol. 2008;87:83–7.CrossRefPubMed
17.
go back to reference Sun W, Nordberg ML, Fowler MR. Histiocytic sarcoma involving the central nervous system: clinical, immunohistochemical, and molecular genetic studies of a case with review of the literature. Am J Surg Pathol. 2003;27:258–65.CrossRefPubMed Sun W, Nordberg ML, Fowler MR. Histiocytic sarcoma involving the central nervous system: clinical, immunohistochemical, and molecular genetic studies of a case with review of the literature. Am J Surg Pathol. 2003;27:258–65.CrossRefPubMed
18.
go back to reference Zhang X, Kryston JJ, Michalak WA, et al. Histiocytic sarcoma in the small intestine: a case report with flow cytometry study and review of the literature. Pathol Res Pract. 2008;204:763–70.CrossRefPubMed Zhang X, Kryston JJ, Michalak WA, et al. Histiocytic sarcoma in the small intestine: a case report with flow cytometry study and review of the literature. Pathol Res Pract. 2008;204:763–70.CrossRefPubMed
19.
go back to reference Akishima Y, Akasaka Y, Yih-Chang G, et al. Histiocytic sarcoma with fatal duodenal ulcers. Pathol Res Pract. 2004;200:473–8.CrossRefPubMed Akishima Y, Akasaka Y, Yih-Chang G, et al. Histiocytic sarcoma with fatal duodenal ulcers. Pathol Res Pract. 2004;200:473–8.CrossRefPubMed
20.
go back to reference Wilson MS, Weiss LM, Gatter KC, et al. Malignant histiocytosis. A reassessment of cases previously reported in 1975 based on paraffin section immunophenotyping studies. Cancer. 1990;66:530–6.CrossRefPubMed Wilson MS, Weiss LM, Gatter KC, et al. Malignant histiocytosis. A reassessment of cases previously reported in 1975 based on paraffin section immunophenotyping studies. Cancer. 1990;66:530–6.CrossRefPubMed
Metadata
Title
Sudden unexpected death from an undiagnosed histiocytic sarcoma in an adolescent female
Authors
H. R. Haynes
Z. Melegh
S. Vanjani
M. Cieka
S. Beavers
N. Rooney
B. Purdue
Publication date
01-12-2016
Publisher
Springer US
Published in
Forensic Science, Medicine and Pathology / Issue 4/2016
Print ISSN: 1547-769X
Electronic ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-016-9800-2

Other articles of this Issue 4/2016

Forensic Science, Medicine and Pathology 4/2016 Go to the issue