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Reticulosarcoma of the skin: causes, symptoms, diagnosis, treatment
Last reviewed: 04.07.2025
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Reticulosarcoma (syn.: reticulosarcoma, histioblastic reticulosarcoma, malignant lymphoma (histiocytic)). This disease is based on the malignant proliferation of histiocytes or other mononuclear phagocytes. Reticulosarcoma includes a heterogeneous group of diseases, mostly of lymphocytic rather than histiocytic origin, more often it consists of B- and less often of T-cells.
Clinically manifested by solitary plaque-like infiltrates or hemispherical dense large nodes. The color of the lesions is yellowish or brownish, sometimes bluish. There is often an ulcer in the center. The tumor metastasizes early.
Pathomorphology. The tumor is characterized by the presence of an infiltrate throughout the entire thickness of the dermis with spread into the subcutaneous tissue. There are undifferentiated and differentiated forms of reticulosarcomas. In the undifferentiated form, the proliferation contains large cells with polymorphic nuclei and mitotic figures. Pleomorphism of the nuclei is expressed in the existence of bizarre nuclei with hyperchromatosis. The cytoplasm of these cells is of varying width and is palely stained.
In the differentiated form, there are round or oval cells with massive pale-stained cytoplasm and paw-shaped or horseshoe-shaped nuclei with clearly expressed nucleoli and coarsely dispersed chromatin. Large cells with massive light cytoplasm and pronounced phagocytic activity are often found between the tumor elements. Fine reticulin fibers surround each cell of the proliferate, but sometimes they are absent. Enzyme cytochemical examination reveals a sharply positive reaction to nonspecific esterase and acid phosphatase both in neoplastic elements and in cells with pronounced phagocytic activity; sometimes, ATPase and beta-glucuronidase activity are determined.
The disease is differentiated primarily from immunoblastic and lymphoblastic lymphomas. Reticulosarcoma cells are significantly larger than neoplastic immunoblasts and do not have cytoplasmic basophilia. However, the final diagnosis is made after cytochemical and immunocytochemical studies.
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