A Case of Histiocytic Sarcoma Presenting with Primary Bone Marrow Involvement

Histiocytic sarcoma (HS) is a very rare neoplasm that often shows an aggressive clinical course and systemic symptoms, such as fever, weight loss, adenopathy, hepatosplenomegaly and pancytopenia. It may present as localized or disseminated disease. We describe here a 63-yr-old male who manifested systemic symptoms, including fever, weight loss and generalized weakness. Abdominal and chest computed tomography failed to show specific findings, but there was suspicion of multiple bony changes at the lumbar spine. Fusion whole body positron emission tomography, bone scan and lumbar spine magnetic resonance imaging showed multiple bone lesions, suggesting a malignancy involving the bone marrow (BM). Several BM and bone biopsies were inconclusive for diagnosis. Necropsy showed replacement of the BM by a diffuse proliferation of neoplastic cells with markedly increased cellularity (95%). The neoplastic cells were positive for lysozyme and CD68, but negative for T- and B-cell lineage markers, and megakaryocytic, epithelial, muscular and melanocytic markers. Morphologic findings also distinguished it from other dendritic cell neoplasms

A Case of Chronic Neutrophilic Leukemia Incidentally Detected by 18F-FDG PET/CT

Chronic neutrophilic leukemia (CNL) is a rare, potentially aggressive, myeloproliferative neoplasm. To the best of our knowledge, there are no previous reports dealing with 18F-FDG PET findings in CNL. We describe a case of CNL in a 69-year-old male, imaged with 18F-FDG PET/CT at diagnosis and during treatment

Reduced NK cell IFN-γ secretion and psychological stress are independently associated with herpes zoster.

The pathogenesis of herpes zoster is closely linked to reduced varicella-zoster virus-specific cell-mediated immunity. However, little is known about the interplay between natural killer cells and psychological stress in the pathogenesis of herpes zoster. This study aimed to investigate possible associations among natural killer cells, T cells and psychological stress in herpes zoster. Interferon-gamma secretion from natural killer cell, psychological stress events, stress cognition scale scores and cytomegalovirus-specific cell-mediated immunity were compared between 44 patients with herpes zoster and 44 age- and gender-matched control subjects. A significantly lower median level of interferon-gamma secreted by natural killer cells was observed in patients with a recent diagnosis of herpes zoster than in control subjects (582.7 pg/ml vs. 1783 pg/ml; P = 0.004), whereas cytomegalovirus-specific cell-mediated immunity was not associated with herpes zoster. Psychological stress events and high stress cognition scale scores were significantly associated in patients with herpes zoster (P<0.001 and P = 0.037, respectively). However, reduced interferon-gamma secretion from natural killer cell and psychological stress were not associated. In conclusion, patients with a recent diagnosis of herpes zoster display reduced interferon-gamma secretion from natural killer cells and frequent previous psychological stress events compared with controls. However, reduced natural killer cell activity is not an immunological mediator between psychological stress and herpes zoster

Comparison of IFN-γ levels secreted from NK cells (A) and CMV-specific T cells (B) from patients with HZ and control subjects.

<p>Median values are depicted with a 95% confidence interval bar. The <i>P</i> value was calculated using the Mann-Whitney U test.</p

Factors affecting IFN-γ levels in NK cells among 44 patients with HZ.

<p>Factors affecting IFN-γ levels in NK cells among 44 patients with HZ.</p

Comparison of laboratory parameters between patients with HZ and control subjects.

<p>Comparison of laboratory parameters between patients with HZ and control subjects.</p

Logistic regression analysis of factors associated with HZ.

<p>Logistic regression analysis of factors associated with HZ.</p

Association between psychological stress and levels of IFN-γ secretion from NK cells.

<p>The stress cognition scale scores were compared (Fig. 3A) between the subjects with psychological stress event (N = 32) and the subjects without psychological event (N = 56). The levels of IFN-γ secretion from NK cells were compared between the subjects with psychological stress event and the subjects without psychological stress event (Fig. 3B). The levels of IFN-γ secretion from NK cells were compared between the subjects (N = 49) with psychological stress cognition scale scores <14 and the subjects (N = 39) with psychological stress cognition scale scores ≥14 (Fig. 3C). The median values are depicted with 95% CIs. <i>P</i> values were calculated using the Mann-Whitney U test.</p

NK cell IFN-γ secretion according to HZ stage.

<p>The difference in levels of IFN-γ secreted from NK cells from subjects in the eruptive stage (N = 18), healing stage (N = 26) and control groups (N = 44) are shown. Median values are depicted with a 95% CI bar and were compared among three groups using the Kruskal-Wallis test (<i>P</i> = 0.0079). Median values were compared between two groups, and <i>P</i> values were adjusted using the Dunn’s multiple comparison test.</p