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Secondary Haemophagocytosis in a Patient with Ewing's Sarcoma

Natasha Ali and Huma Mansoori

Secondary haemophagocytosis in malignant tumours have been reported in bone marrow. However we present engulfment of malignant apoptotic Ewing’s sarcoma cells by macrophages in the bone marrow. A 24 year old Pakistani male patient presented with complains of backache. After imaging, a laminectomy was performed the biopsy results of which were consistent with Ewing’s sarcoma. Subsequently for staging, bone marrow and trephine was done. The bone marrow aspirate showed markedly increased haemophagocytic activity with histiocytes engulfing malignant apoptotic Ewing’s sarcoma cells. The presence of histiocytes engulfing apoptotic Ewing’s sarcoma cells was of particular interest. Similar findings have rarely been reported.