1
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Weimholt C, Jalaly JB, Bailey C. Cytomorphology of follicular dendritic cell sarcoma: a report of 7 cases with an emphasis on the diagnostic challenges. J Am Soc Cytopathol 2023; 12:229-238. [PMID: 36702737 DOI: 10.1016/j.jasc.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/20/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023]
Abstract
BACKGROUND Follicular dendritic cell sarcoma is a malignant neoplasm derived from germinal center follicular dendritic cells, which both share a characteristic immunophenotype (namely CD21, CD23, and CD35). Cytomorphologic descriptions are few, consisting of only 26 prior cases from 24 publications. Identification by cytologic means appears challenging as the majority of previous reports disclose an erroneous or indeterminate initial cytologic diagnosis. Herein, we present the largest cytology series to date with the aim of expanding upon this small body of literature and discuss possible factors resulting in misinterpretation. MATERIALS AND METHODS A retrospective search was conducted from 2 academic medical centers to identify histologically confirmed cases of follicular dendritic cells with an associated cytologic component. Clinicopathologic data were tabulated and a comparative analysis of cytomorphologic and immunohistochemical features was performed. RESULTS Seven separate cases were identified. All cases showed cohesive tumor cells with a characteristic voluminous, ill-defined cytoplasm with interconnecting fibrillary processes and intimately admixed mature lymphocytes. Features were maintained across various cytologic preparations, including conventional smear, liquid-based cytology, and touch imprint. Unusual immunohistochemical profiles were noted in a subset of cases. CONCLUSIONS Cytomorphology is highly conserved across cases and preparations; however, a propensity for aberrant immunoexpression may contribute to diagnostic errors. Cytomorphologic features, supported by immunohistochemistry, suggest fine-needle aspiration as a reasonable diagnostic modality. Tumors with these features should include CD21, CD23, and/or CD35 in the workup.
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Affiliation(s)
- Cody Weimholt
- Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
| | - Jalal B Jalaly
- Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Cedric Bailey
- Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
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2
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Xia R, Shafizadeh N, Brandler T, Liu C, Oweity T. Follicular dendritic cell sarcoma of the cervical lymph node diagnosed on fine needle aspiration cytology. Cytopathology 2021; 33:119-122. [PMID: 34351024 DOI: 10.1111/cyt.13047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/07/2021] [Accepted: 08/02/2021] [Indexed: 11/28/2022]
Abstract
Follicular dendritic cell sarcomas (FDCS) are rare tumours of lymph nodes and extranodal tissues which are grouped with the histiocytic and dendritic cell neoplasms. The diagnosis is usually made after thorough clinical and pathological examination with immunohistochemical analysis. Difficulties persist in diagnosing FDCS on cytological preparations. We report herein a case of a 57-year-old female who presented with a right neck mass of 5 months duration. Computed Tomography (CT) imaging of the neck reported a necrotic right level IIb lymph node and asymmetric fullness of the right palatine tonsil. Fine needle aspiration (FNA) biopsy revealed numerous spindle, oval and stellate neoplastic cells, arranged singly and in syncytia with moderate nuclear pleomorphism, vesicular chromatin pattern, and prominent nucleoli, sprinkled with small lymphocytes. The tumour cells were strongly diffusely positive for CD21, CD23, and D2-40 immunostaining on cell bock sections, but were negative for CD1a and CD34, supporting the diagnosis of FDCS. Follow-up surgical pathology on the resection showed histopathological features and an immunohistochemical profile consistent with FDCS.
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Affiliation(s)
- Rong Xia
- Department of Pathology, New York University Langone Health, New York, NY, USA
| | - Negin Shafizadeh
- Department of Pathology, New York University Langone Health, New York, NY, USA
| | - Tamar Brandler
- Department of Pathology, New York University Langone Health, New York, NY, USA
| | - Cheng Liu
- Department of Pathology, New York University Langone Health, New York, NY, USA
| | - Thaira Oweity
- Department of Pathology, New York University Langone Health, New York, NY, USA
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3
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Walke VA, Agale SV, Patil PK. Encounter with unusual tumor having classic cytomorphology presenting as neck mass. Cytojournal 2021; 18:6. [PMID: 33880129 PMCID: PMC8053476 DOI: 10.25259/cytojournal_20_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/08/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- Vaishali Atmaram Walke
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Shubhangi Vinayak Agale
- Department of Pathology, Grant Government Medical College and JJ Group of Hospital, Maharashtra, India
| | - Purwa Kishor Patil
- Department of Pathology, Grant Government Medical College, Mumbai, Maharashtra, India
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Asiry S, Khader SN, Villanueva-Siles E, Hakima L. Follicular dendritic cell sarcoma: Cytomorphologic features and diagnostic challenges. Diagn Cytopathol 2021; 49:457-461. [PMID: 33418601 DOI: 10.1002/dc.24691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/24/2020] [Accepted: 12/23/2020] [Indexed: 01/10/2023]
Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare malignant neoplasm, which primarily arises in lymph nodes with occasional cases occurring in extranodal locations. The diagnosis is often challenging particularly on cytology fine needle aspiration due to overlapping morphologic and immunohistochemical features. We present a case of FDCS diagnosed in an otherwise asymptomatic 33-year old male. The aim of our case report is to highlight the key cytomorphologic features and discuss various differential diagnoses of this unusual entity.
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Affiliation(s)
- Saeed Asiry
- The Leopold G. Koss Division of Cytopathology, Montefiore Hospital and Medical Center/Albert Einstein College of Medicine, New York, New York, USA
| | - Samer N Khader
- Division of Cytopathology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
| | - Esperanza Villanueva-Siles
- The Department of Pathology, Montefiore Hospital and Medical Center/Albert Einstein College of Medicine, New York, New York, USA
| | - Laleh Hakima
- The Department of Pathology, Montefiore Hospital and Medical Center/Albert Einstein College of Medicine, New York, New York, USA
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Abdou AG, Asaad N, Aiad H, Shams A, Said A, Eldein MS. Fine-Needle Aspiration Cytology of Follicular Dendritic Cell Sarcoma of Cervical Lymph Node: A Challenging Diagnosis. J Microsc Ultrastruct 2019; 7:143-145. [PMID: 31548927 PMCID: PMC6753701 DOI: 10.4103/jmau.jmau_57_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare malignant tumor that could arise in both nodal and extranodal sites, with only nine previously reported cases demonstrating cytologic features. In this report, we describe a case of FDCS in a 60-year-old female who presented with neck mass. Fine-needle aspiration cytology and subsequent core biopsy were suggestive of metastatic carcinoma. The cytologic features were epithelioid-to-spindle cell morphology, vesicular nuclei, prominent nucleoli, intranuclear inclusions, and occasional binucleated and multinucleated forms. However, absence of cytokeratin expression was against the diagnosis of metastatic carcinoma. The definitive diagnosis was reached by the demonstration of CD21 and CD23 expression. The pathologist should be aware of this rare malignant tumor, especially its cytologic features in aspirated material. The differential diagnosis in the above case was metastatic carcinoma, melanoma, and malignant granular cell tumor. The demonstration of expression of one or more dendritic cell marker is the clue for the diagnosis, which could be applied on cytological preparations with sufficient material.
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Affiliation(s)
- Asmaa Gaber Abdou
- Department of Pathology, Faculty of Medicine, Menoufia University, Shebein Elkom, Egypt
| | - Nancy Asaad
- Department of Pathology, Faculty of Medicine, Menoufia University, Shebein Elkom, Egypt
| | - Hayam Aiad
- Department of Pathology, Faculty of Medicine, Menoufia University, Shebein Elkom, Egypt
| | - Asmaa Shams
- Department of Pathology, Faculty of Medicine, Menoufia University, Shebein Elkom, Egypt
| | - Abdelnabei Said
- Department of Pathology, Faculty of Medicine, Menoufia University, Shebein Elkom, Egypt
| | - Marwa Serag Eldein
- Department of Pathology, Faculty of Medicine, Menoufia University, Shebein Elkom, Egypt
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6
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Dutta A, Arun P, Roy P, Arun I. Cytological diagnosis of follicular dendritic cell sarcoma: A case report and review of literature. Cytopathology 2018; 29:461-467. [PMID: 29683532 DOI: 10.1111/cyt.12558] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 12/18/2022]
Affiliation(s)
- A. Dutta
- Department of Pathology; Tata Medical Center; Kolkata West Bengal India
| | - P. Arun
- Department of Head and Neck Surgery; Tata Medical Center; Kolkata West Bengal India
| | - P. Roy
- Department of Pathology; Tata Medical Center; Kolkata West Bengal India
| | - I. Arun
- Department of Pathology; Tata Medical Center; Kolkata West Bengal India
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7
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Ojha SS, Jain R, Meenai F, Nilkanthe R, Haritwal A. Cytomorphological Findings of Follicular Dendritic Cell Sarcoma on Fine-Needle Aspiration Cytology. Acta Cytol 2017; 62:145-150. [PMID: 29275417 DOI: 10.1159/000485789] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 11/28/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm arising from follicular dendritic cells of germinal centers. The most common site of origin is lymph nodes and it may mimic a variety of tumors at that location, including carcinomas and sarcomas. Diagnosis is frequently missed on cytology as there are very few case reports describing the cytological characteristics of the lesion. Even on histology, a high degree of suspicion is required for an appropriate diagnosis. CASE A 60-year-old male presented with a gradually increasing left submandibular mass that had been present for 3 months. Fine-needle aspiration cytology (FNAC) was performed, showing many clusters as well as scattered epithelioid cells with spindled to oval nuclei, nuclear pleomorphism, grooves, inclusions, and uniformly dispersed mature lymphocytes throughout the smears. The diagnosis of FDCS was suspected and was confirmed on histopathology and immunohistochemistry. CONCLUSION FNAC can be a cheap, easy, and helpful tool in obtaining a diagnosis of FDCS as there are few characteristic cytological features that are better recognized than histology.
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Affiliation(s)
- Sandeep S Ojha
- Department of Pathology, Chirayu Medical College and Hospital, Bhopal, India
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Abstract
RATIONALE Follicular dendritic cell sarcoma (FDCS) is a rare neoplasia composed of spindle or oval cells with follicular dendritic cell differentiation, usually occurring in lymphoid tissue. In this report, we present a case of FDCS of the small intestine with liver metastasis. PATIENT CONCERNS A 19-year-old female presented with recent onset of left upper abdominal pain. Abdominal computed tomography scan showed a large tumor mass in the liver lateral segment with compression to the pancreas upper part, and a smaller mass in the terminal ileum, respectively. High serum levels of amylase and lipase were noted. Resection of the tumors was performed. Microscopically, both tumors consisted of ovoid to spindle-shaped nuclei cells admixed with some lymphocytes arranged in fascicles, whorls, storiform arrays. Immunohistochemistry demonstrated that the tumor cells were positive for follicular dendritic cell markers, including CD21, CD23, and CD35. Epstein-Barr virus encoding small RNA (EBER; Inform EBER probe; Ventana Medical Systems, Tucson, AZ) in situ hybridization was negative. DIAGNOSES According to the clinicopathological features, diagnosis of FDCS of intestinal origin was made. INTERVENTIONS Resection of tumors located in the liver and at the small intestine was performed. After the operation, patient received adjuvant vinblastin chemotherapy. OUTCOMES There was no evidence of recurrence at 8-month follow-up. LESSONS It was unusual for FDCS of intestinal origin with liver metastasis and expressing with high serum levels of pancreatic enzymes.
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Affiliation(s)
- Yun-Chen Chang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ivy Yenwen Chau
- Poznan University of Medical Science Medical Faculty II, Poznan, Poland
- Division of General Surgery, Department of Surgery
| | - Yi-Chen Yeh
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Gar-Yang Chau
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of General Surgery, Department of Surgery
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Hang JF, Wang LC, Lai CR. Cytological features of inflammatory pseudotumor-like follicular dendritic cell sarcoma of spleen: A case report. Diagn Cytopathol 2016; 45:230-234. [PMID: 27775241 DOI: 10.1002/dc.23626] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 09/13/2016] [Accepted: 10/12/2016] [Indexed: 12/21/2022]
Abstract
Here, we present the first cytological report of a primary splenic inflammatory pseudotumor-like follicular dendritic cell sarcoma. The 57 year-old male was incidentally found with a 2.2 cm well-demarcated splenic nodule. A sonography guided fine needle aspiration of the lesion was performed. The cytologic smears revealed loosely cohesive fragments of oval to spindle cells in a background of prominent lymphoplasmacytic infiltration. The cells showed sparse chromatin, distinct nucleoli, syncytial cell borders, and occasional cytoplasmic processes. On the liquid-based preparation, several histiocyte-like cells with emperipolesis phenomenon were noted. Scant large atypical cells with prominent, cherry-red nucleoli were found on the cell block sections. The initial cytologic interpretation was "atypical cells cannot exclude classical Hodgkin lymphoma." The subsequent partial splenectomy showed an inflammatory pseudotumor-like follicular dendritic cell sarcoma. The tumor cells were positive for CD21, CD35, smooth muscle actin, and EBER in situ hybridization. The cytologic differential diagnoses are briefly discussed. The knowledge of this rare entity, awareness of its cytomorphology, and proper ancillary tests would be helpful for correct cytologic diagnosis. Diagn. Cytopathol. 2017;45:230-234. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jen-Fan Hang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Lei-Chi Wang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chiung-Ru Lai
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Wang RF, Han W, Qi L, Shan LH, Wang ZC, Wang LF. Extranodal follicular dendritic cell sarcoma: A clinicopathological report of four cases and a literature review. Oncol Lett 2014; 9:391-398. [PMID: 25435998 PMCID: PMC4247019 DOI: 10.3892/ol.2014.2681] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 10/20/2014] [Indexed: 12/15/2022] Open
Abstract
The aim of the present study was to characterize the clinicopathological features of follicular dendritic cell sarcoma (FDCS), and to report the experience of the Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine (Shanghai, China) with this entity. The clinicopathological findings of four cases that had recently been encountered and 142 previously reported cases in the English literature were evaluated. The current tumors were found in two male and two female patients, aged 49–76 years old, who exhibited a mean tumor size of 8.7 cm. Three of the four cases were misdiagnosed during the initial diagnosis and one experienced intra-abdominal recurrence six months after the first diagnosis. Assessment of all 142 cases in the literature revealed a mild female predominance. The tumors exhibited a mean tumor size of ~7.0 cm. Histologically, the tumors were composed of plump spindle- or oval-shaped cells that exhibited eosinophilic cytoplasm and were arranged in sheets, storiform patterns or whorls. Immunohistochemically, the neoplastic cells expressed at least one of the FDC markers. Among the 130 cases with follow-up data, the overall recurrence, metastasis and mortality rates were 49.2% (64 cases), 21.5% (28 cases), and 13.8% (18 cases), respectively. FDCS can appear deceptively similar to other soft-tissue tumors, even poorly-differentiated carcinomas. A correct diagnosis requires a high degree of suspicion and immunohistochemical evaluation.
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Affiliation(s)
- Rui-Fen Wang
- Department of Pathology, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, P.R. China
| | - Wei Han
- Department of Pathology, The First Hospital of Harbin Medical University, Harbin 150001, P.R. China
| | - Lei Qi
- Department of Pathology, The First Hospital of Harbin Medical University, Harbin 150001, P.R. China
| | - Li-Hui Shan
- Department of Pathology, The First Hospital of Harbin Medical University, Harbin 150001, P.R. China
| | - Zheng-Cai Wang
- Department of Pathology, The Fourth Hospital of Harbin Medical University, Harbin 150001, P.R. China
| | - Li-Feng Wang
- Department of Pathology, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, P.R. China
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Rao L, Yang Z, Wang X, Zhang X, Shen B. Imaging findings of inflammatory pseudotumor-like follicular dendritic cell tumor of spleen. Clin Nucl Med 2014; 39:e286-9. [PMID: 23751835 DOI: 10.1097/rlu.0b013e3182952bfe] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Inflammatory pseudotumor-like follicular dendritic cell tumor (IPT-like FDCT) histology is similar to that of the classical follicular dendritic cell (FDC) tumor, but, in addition, the inflammatory component is quite prominent. We report a case of IPT-like FDCT of the spleen by abdominal CT and 18F-FDG PET/CT. Abdominal CT showed a low-density, round, well-circumscribed defined mass in spleen, and the mass showed a high metabolism rate on 18F-FDG PET/CT.
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Affiliation(s)
- Liangjun Rao
- From the Department of Radiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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12
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Saygin C, Uzunaslan D, Ozguroglu M, Senocak M, Tuzuner N. Dendritic cell sarcoma: a pooled analysis including 462 cases with presentation of our case series. Crit Rev Oncol Hematol 2013; 88:253-71. [PMID: 23755890 DOI: 10.1016/j.critrevonc.2013.05.006] [Citation(s) in RCA: 157] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 03/16/2013] [Accepted: 05/08/2013] [Indexed: 02/06/2023] Open
Abstract
Dendritic cell tumors are extremely rare and current knowledge on these tumors is limited. The characteristics of three dendritic cell sarcoma subtypes and their optimal treatment approaches are not fully clarified. We aimed to make a systematic review of the literature and enrich the current data with five new cases. Pooled analysis of 462 reported cases revealed that the tumor had no age, gender or racial predilection. Our analysis suggests that the young age, advanced stage, intraabdominal involvement and unfavorable histological features (i.e. large tumor size, absence of lymphoplasmacytic infiltration, coagulative necrosis, high mitotic count) may predict poor prognosis. Subtypes of this tumor have different clinical behaviors with interdigitating dendritic cell sarcoma being the most aggressive form. In general, surgery is the most effective treatment modality and adjuvant radiotherapy has no significant effect on overall survival of patients. The role of chemotherapy for the management of advanced disease is controversial.
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Affiliation(s)
- Caner Saygin
- Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
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Kara T, Serinsoz E, Arpaci RB, Vayisoglu Y. Follicular dendritic cell sarcoma of the tonsil. BMJ Case Rep 2013; 2013:bcr-2012-007440. [PMID: 23365157 DOI: 10.1136/bcr-2012-007440] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Follicular dendritic cell sarcoma (FDCS) is an uncommon tumour within the spectrum of histiocytic and dendritic cell neoplasms that can occur at nodal and extra-nodal sites. Besides being rare, these tumours are difficult to diagnose. A 72-year-old man with a painless mass in the right tonsil was admitted to the Mersin University Hospital. Tonsillectomy was performed. Microscopically, the tumour consisted of spindle-shaped cells with large oval to polygonal nuclei. Lymphocytes were scattered among the tumour cells. Immunohistochemically, the cells were positive for CD23 and vimentin. The tumour was diagnosed as FDCS with histological and immunohistochemical findings. Recognition of extranodal FDCS requires knowledge of this entity and to consider it during the diagnosis. Confirmatory immunohistochemical staining is essential for diagnosis. Correct characterisation of this neoplasm is important because of its potential for recurrence and metastasis.
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Affiliation(s)
- Tuba Kara
- Department of Pathology, Mersin University, School of Medicine, Mersin, Turkey
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14
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Qian X, Hornick JL, Cibas ES, Cin PD, Domanski HA. Angiomatoid fibrous histiocytoma a series of five cytologic cases with literature review and emphasis on diagnostic pitfalls. Diagn Cytopathol 2011; 40 Suppl 2:E86-93. [DOI: 10.1002/dc.21830] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 08/09/2011] [Indexed: 11/09/2022]
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15
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Lee CH, Yen YS, Shan YS, Lin PW. Follicular Dendritic Cell Tumor in Liver: A Case Report and Collective Review. Gastroenterology Res 2010; 3:139-143. [PMID: 27942292 PMCID: PMC5139768 DOI: 10.4021/gr2010.05.206w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2010] [Indexed: 12/15/2022] Open
Abstract
Follicular dendritic cells (FDC) are a subset of the immune system and present in the germinal centers of lymphoid follicles in the spleen and lymph nodes. They are functionally as antigen-presenting cells and thus improving the quality of the humoral immune response. Follicular dendritic cell tumor is rare but considered low-grade sarcoma. Including our case, there were totally 17 cases with FDC tumor involved the liver from Medline. In these cases, the mean age was 47 years old, ranged from 19 to 82. It was much more common in females than in males (13:4). The clinical manifestations of these patients included abdominal discomfort, palpable mass, weight loss and malaise. The average size of the tumor was 11 cm. Most of the FDC tumors were associated with Epstein-Barr virus expression, 13/17 (76.5%). Surgical resection remains the mainstay of the treatment.
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Affiliation(s)
- Chee-Hwee Lee
- Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| | - Yu-Shan Yen
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| | - Yan-Shen Shan
- Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| | - Pin-Wen Lin
- Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
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16
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Song JY, Jin XJ, Han JY, Kim L, Park IS, Kim JM, Chu YC, Choi SJ. Cytology of Follicular Dendritic Cell Sarcoma on Intraoperative Touch Imprint Smears - A Case Report -. KOREAN JOURNAL OF PATHOLOGY 2009. [DOI: 10.4132/koreanjpathol.2009.43.6.589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Ju Young Song
- Department of Pathology, Inha University Hospital, Incheon, Korea
| | - Xian Ji Jin
- Department of Pathology, Inha University Graduate School of Medicine, Incheon, Korea
| | - Jee Young Han
- Department of Pathology, Inha University Hospital, Incheon, Korea
| | - Lucia Kim
- Department of Pathology, Inha University Hospital, Incheon, Korea
| | - In Suh Park
- Department of Pathology, Inha University Hospital, Incheon, Korea
| | - Joon Mee Kim
- Department of Pathology, Inha University Hospital, Incheon, Korea
| | - Young Chae Chu
- Department of Pathology, Inha University Hospital, Incheon, Korea
| | - Suk Jin Choi
- Department of Pathology, Inha University Hospital, Incheon, Korea
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17
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Granados R, Aramburu JA, Rodríguez JM, Nieto MA. Cytopathology of a primary follicular dendritic cell sarcoma of the liver of the inflammatory pseudotumor-like type. Diagn Cytopathol 2008; 36:42-6. [PMID: 18064686 DOI: 10.1002/dc.20744] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Follicular dendritic cell (FDC) sarcoma is an exceedingly uncommon tumor of lymph nodes and extranodal tissues. The inflammatory pseudotumor (IPT)-like variant of FDC sarcoma of intraabdominal location is considered a separate entity, with different clinical and pathological features than those of the classic FDC tumor. There have been only 12 cytological reports of FDC sarcomas in the literature. Two of them were metastases to the liver and, like our case, had features of IPT. Fine-needle aspiration biopsy (FNAB) and imprint and scrape cytology from the surgically excised tumor here reported revealed spindle tumor cells with moderate pleomorphism, nuclear grooves, prominent nucleoli, and cytoplasmic processes, admixed with inflammatory cells. To the best of our knowledge, this is the first cytology report of a primary hepatic FDC tumor. The cytological findings permit the recognition of this tumor. However, confirmation by inmunohistochemistry (IHQ) is mandatory for a definitive diagnosis.
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Affiliation(s)
- Rosario Granados
- Department of Pathology, Hospital Universitario de Getafe, Madrid, Spain.
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18
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Xie Y, Yang H, Miller JH, Shih DM, Hicks GG, Xie J, Shiu RP. Cells deficient in oxidative DNA damage repair genes Myh and Ogg1 are sensitive to oxidants with increased G 2 /M arrest and multinucleation. Carcinogenesis 2008; 29:722-8. [DOI: 10.1093/carcin/bgn033] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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De Pas T, Spitaleri G, Pruneri G, Curigliano G, Noberasco C, Luini A, Andreoni B, Testori A, de Braud F. Dendritic cell sarcoma: an analytic overview of the literature and presentation of original five cases. Crit Rev Oncol Hematol 2007; 65:1-7. [PMID: 17658269 DOI: 10.1016/j.critrevonc.2007.06.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2006] [Accepted: 06/07/2007] [Indexed: 10/23/2022] Open
Abstract
Interdigitating and follicular dendritic cell sarcoma (DCS) are very rare diseases, with approximately 184 cases being reported thus far, and their best treatment modality is still on debate. This is a review of all the cases of dendritic cell sarcoma reported from 1981 until April 2006. This review is enriched with the original contribution of five cases occurred at our Institution from 1994 to 2006. The review of the literature pointed out that radical surgery alone was curative in approximately two thirds of these cases, the relapsing rate in patients who received adjuvant treatments being higher than 30%. We pinpoint new five cases of dendritic cell sarcoma (three FDCS and two IDCS). Both the analytic revision of the literature and our data suggest that localized DCS may be effectively treated by radical surgery and do not support the use of adjuvant treatments after radical excision.
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Affiliation(s)
- Tommaso De Pas
- New Drugs Development and Clinical Pharmacology Unit, Department of Medicine, European Institute of Oncology, Milan, Italy.
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Bai LY, Kwang WK, Chiang IP, Chen PM. Follicular dendritic cell tumor of the liver associated with Epstein-Barr virus. Jpn J Clin Oncol 2006; 36:249-53. [PMID: 16533803 DOI: 10.1093/jjco/hyl001] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Follicular dendritic cell tumors are an uncommon neoplasm. About half of all cases occur in the lymph nodes, especially in the neck region. Follicular dendritic cell tumors of the liver are even rarer. In this article we report a case of a hepatic follicular dendritic cell tumor. A 30-year-old female was noted to have a hepatic mass 6 cm in size in segment 6. The patient underwent a right lobectomy of the liver. Microscopically, the lesion was an admixture of spindle cells and inflammatory cells, chiefly lymphocytes, plasma cells, histiocytes and a few neutrophils. The spindle cells were arranged in a wavy pattern, with a vague cellular border and eosinophilic cytoplasm. These tumor cells were immunoreactive to CD21 and CD68. The test for Epstein-Barr virus (EBV)-encoded nuclear RNAs using in situ hybridization was also positive. Although hepatic follicular dendritic cell tumors appear similar to conventional inflammatory pseudotumors in terms of histology, they should be regarded as a clonal proliferation of follicular dendritic cells. In contrast to follicular dendritic cell tumors in extrahepatic areas, hepatic follicular dendritic cell tumors have a strong association with EBV and a greater inflammatory component and are more prevalent in females.
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Affiliation(s)
- Li-Yuan Bai
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
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