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Reticulosarcoma of the skin: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Reticulosarcoma (syn: retotelsarcoma, histoblastic reticulosarcoma, malignant lymphoma (histiocytic)). At the heart of this disease is the malignant proliferation of histiocytes or other mononuclear phagocytes. To reticulosarcoma is a heterogeneous group of diseases, mostly not histiocytic, but of lymphocytic origin, more often it consists of B- and less often from T cells.
Clinically manifested by solitary plaque-like infiltrates or hemispherical dense large nodes. The color of lesions is yellowish or brownish, sometimes cyanotic. Often there is ulceration in the center. The tumor early metastasizes.
Pathomorphology. The tumor is characterized by the presence of an infiltrate in the entire thickness of the dermis with proliferation into the subcutaneous tissue. There are nondifferentiated and differentiated forms of reticulosarcoma. With an undifferentiated form in the proliferation there are large cells with polymorphic nuclei and mitosis figures. Pleomorphism of nuclei is expressed in the existence of fanciful nuclei with hyperchromatosis. The cytoplasm of these cells of different widths is pale.
In a differentiated form, there are cells of round or oval shape with a massive pale-colored cytoplasm and tarsus or horseshoe-shaped nuclei with distinct nucleoli and large-dispersed chromatin. Between the tumor elements are often large cells with massive light cytoplasm and pronounced phagocytic activity. Thin reticulin fibers surround each cell of the proliferative, but sometimes they are absent. In the case of cytocimochemical examination, a sharply positive reaction to nonspecific esterase and acid phosphatase occurs both in neoplastic elements and in cells with pronounced phagocytic activity, and sometimes the activity of ATPase and beta-glucuronidase is determined.
Differentiate the disease primarily from immunoblastic and lymphoblastic lymphomas. The cells of the reticulosarcoma are much larger than the neoplastic immunoblasts, and they do not have the basophilia of the cytoplasm. However, the final diagnosis is made after cytochemical and immunocytochemical studies.
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