Histiocytic Sarcoma Associated with Coombs Negative Acute Hemolytic Anemia: A Rare Presentation

Figure 2

Peripheral blood smear and histopathology of the spleen. (a) Prechemotherapy peripheral blood smear with anisopoikilocytosis, numerous spherocytes (white arrows), tear drop cell (black arrow), and decreased platelets; (b) massively enlarged, surgically removed spleen (weight = 1770 grams; 24 × 14 × 11 cm in size); (c) histological sections of the spleen revealed sheets of atypical cells with a high nuclear to cytoplasmic ratio, prominent nucleoli, and an abundant eosinophilic cytoplasm (400x magnification); (d, e, and f) areas of spleen involved with HS demonstrated strong and diffuse immunoreactivity with macrophage-specific markers (CD68 PGM (d), CD68 KP1 (e), and lysozyme (f)) [7].

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