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Din NU, Ahmad Z, Rahim S, Fritchie K, Tariq MU, Ahmed A. Extranodal Follicular Dendritic Cell Sarcoma of the Head and Neck Region: A Clinicopathological Study of 7 Cases. Int J Surg Pathol 2023; 31:1067-1074. [PMID: 36426540 DOI: 10.1177/10668969221133352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Background. Follicular dendritic cell (FDC) sarcoma is a rare neoplasm arising from follicular dendritic cells (FDCs). It can be nodal or extranodal. Histological diagnosis of extranodal FDC sarcoma in the head and neck region is challenging and a significant percentage are misdiagnosed. Objectives. To report clinicopathological features of head and neck extranodal FDC sarcoma cases and discuss differential diagnoses. Methods. Seven head and neck extranodal FDC sarcomas were retrieved and clinicopathological features were noted. Results. Two tumors each involved parapharyngeal space and tonsil while remaining cases involved the parotid, soft tissue of neck and oropharynx. Age range was 12 to 79 years (mean and median age were 40 and 44 years respectively) and there was a male predilection (6 males: 1 female). All showed spindle to ovoid cells arranged in fascicles, whorls and/or storiform pattern. Mitoses ranged from 3 to 20/mm2. All tumors expressed CD21 and CD23. Two patients died of their disease at 9 and 16 months. Both had tumors larger than 5 cm with ≥10 mitoses/mm2. Three patients were alive at 12, 44 and 184 months. Conclusions. There was a distinct male predominance in our cohort. FDC sarcoma should be included in the differential diagnosis of spindle cell extranodal neoplasms in the head and neck with a whorled growth pattern and intratumoral lymphocytes. Head and neck region tumors show similar clinicopathologic characteristics as their counterparts at other locations with potential for aggressive behavior especially in tumors greater than 5 cm in size and with high mitotic rates.
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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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Zhao X, Sun D, Zhang G. Clinicopathological characteristics of extranodal follicular dendritic cell sarcoma: A report of two cases. Oncol Lett 2021; 21:182. [PMID: 33574921 PMCID: PMC7816366 DOI: 10.3892/ol.2021.12443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 11/20/2020] [Indexed: 11/09/2022] Open
Abstract
Follicular dendritic cell sarcoma (FDCS) is an extremely rare tumor, which mainly originates from FDCs in the lymph nodes. Sometimes FDCS can arise from outside the lymph nodes due to the existence of acquired lymphoid tissue, which becomes the histological basis of the tumor. The diagnosis of FDCS, particularly extranodal FDCS, presents a challenge for pathologists and hematopathologists. The present study presents two cases of extranodal FDCS based on clinical features and histomorphology. Soft tissue of the chest wall was involved in case 1 and right tonsil tissue in case 2. Case 1 underwent surgery, and was in good health post-operatively. During the 5-month post-operative follow-up period, the patient was healthy in all respects. Case 2 received surgery combined with radiotherapy, and the follow-up data reported that the patient remained alive, without signs of recurrence or metastasis during the 4-month post-operative follow-up period. Additionally, a total of 102 cases of extranodal FDCS were retrieved from the literature, which were extracted and reviewed carefully. The rates of recurrence, metastasis and mortality were 14.63 (12/82), 17.07 (14/82) and 8.29% (15/82), respectively. The overall survival rates of the 102 cases, showing 2-year total survival rates, were 70%, the same with that of 5-year total survival rates. The 2-year tumor-free total survival rates were 68%, and the 5-year equivalents were 32%. Female patients had a poorer prognosis than male patients (P<0.05). Kaplan-Meier estimation presented no statistically significant differences between disease-free survival rates or overall survival rates and age, tumor size or treatment (P>0.05).
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Affiliation(s)
- Xing Zhao
- Department of Pathology, Affiliated Hospital of Chengde Medical College, Chengde, Hebei 067000, P.R. China
| | - Dayong Sun
- Department of Tumor Radiation and Chemotherapy Center, Chengde Central Hospital, Chengde, Hebei 067000, P.R. China
| | - Gang Zhang
- Department of General Surgery IV, Baoding First Hospital, Baoding, Hebei 071000, P.R. China
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Das DK, Pathan SK, Sheikh ZA, Mallik MK, John B, Mothaffer F. Fine-Needle Cytological Characteristics of Carcinoma Breast with Medullary or Medullary-like Features Masquerading as Dendritic Reticulum Cell Sarcoma: An Attempt to Explore the Reasons for Erroneous Cytologic Interpretation. J Cytol 2020; 37:99-107. [PMID: 32606498 PMCID: PMC7315914 DOI: 10.4103/joc.joc_15_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 03/18/2020] [Indexed: 11/11/2022] Open
Abstract
Background: Infiltration of tumors by dendritic reticulum cells (DRC) reflects the host immune defense mechanism. We observed three breast carcinomas cases with dense tumor-infiltrating DRC and lymphocytes in fine-needle aspiration (FNA) smears, leading to cytodiagnosis or differential diagnosis of dendritic reticulum cell sarcoma (DRCS). An attempt was made to find out the reason behind such an erroneous interpretation. Materials and Methods: Between 2009 and 2014, two cases were diagnosed as DRCS of the female breast by FNA cytology and in one case possibility of DRCS was considered along with medullary breast carcinoma (MBC). We compare and contrast the cytomorphological features of these three cases with those of nine cytologically diagnosed MBC. Results: Cases diagnosed as DRCS or MBC showed singly dispersed tumor cells, nuclear pleomorphism, bare nuclei, prominent nucleoli, and presence of lymphocytes. There was no significant difference between the two groups for discohesive clusters, syncytial clusters, plasma cells, neutrophils, foamy histiocytes, and necrosis. However, there was significant difference for presence of cohesive clusters (0% DRCS and 100% MBC, P = 0.00485), severe degree (+++) of pleomorphism (100% DRCS vs. 11.1% MBC, P = 0.01818), +++ DRC (P = 0.04697), and DRC with ++ to +++ enlarged nuclei (P = 0.03333), and pleomorphic nuclei (P = 0.00833). Two of the three cytologically diagnosed DRCS cases proved to be MBC or MBC-like and one as invasive ductal carcinoma. Six of nine cytologically diagnosed MBC cases with histology proved to be invasive breast carcinomas. Conclusion: Criteria for cytodiagnosis MBC need a fresh look. Cases with numerous dendritic cells possibly represent MBC.
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Affiliation(s)
- Dilip K Das
- Department of Pathology, Faculty of Medicine, Kuwait University, and Cytology and Histopathology Units, Mubarak Al-Kabeer Hospital, Kuwait
| | - Shahed K Pathan
- Department of Pathology, Faculty of Medicine, Kuwait University, and Cytology and Histopathology Units, Mubarak Al-Kabeer Hospital, Kuwait
| | - Zafar A Sheikh
- Department of Pathology, Faculty of Medicine, Kuwait University, and Cytology and Histopathology Units, Mubarak Al-Kabeer Hospital, Kuwait
| | - Mrinmay K Mallik
- Department of Pathology, Faculty of Medicine, Kuwait University, and Cytology and Histopathology Units, Mubarak Al-Kabeer Hospital, Kuwait
| | - Bency John
- Department of Pathology, Faculty of Medicine, Kuwait University, and Cytology and Histopathology Units, Mubarak Al-Kabeer Hospital, Kuwait
| | - Fatma Mothaffer
- Department of Pathology, Faculty of Medicine, Kuwait University, and Cytology and Histopathology Units, Mubarak Al-Kabeer Hospital, Kuwait
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Hutchison B, Sadigh S, Ferry JA, Shattuck TM, Faquin WC. Tonsillar p16-Positive Follicular Dendritic Cell Sarcoma Mimicking HPV-Related Oropharyngeal Squamous Cell Carcinoma: A Case Report and Review of Reported Cases. Head Neck Pathol 2020; 15:267-274. [PMID: 32189159 PMCID: PMC8010052 DOI: 10.1007/s12105-020-01152-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/09/2020] [Indexed: 12/20/2022]
Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare entity which can share morphologic features with non-keratinizing squamous cell carcinoma. Recent reports suggest that up to half of FDCSs show immunohistochemical positivity for p16 (Zhang et al., in Hum Pathol 66:40-47, 2017), a stain that is conventionally used in the risk stratification of oropharyngeal squamous cell carcinoma (OPSCC). Herein, we report a case of p16-positive FDCS with clinical and histomorphologic overlap with human papilloma virus (HPV)-related OPSCC.
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Affiliation(s)
- Bailey Hutchison
- Department of Pathology, Massachusetts General Hospital, Boston, MA USA
| | - Sam Sadigh
- Department of Pathology, Massachusetts General Hospital, Boston, MA USA
| | - Judith A. Ferry
- Department of Pathology, Massachusetts General Hospital, Boston, MA USA
| | - Trisha M. Shattuck
- Carolinas Pathology, Atrium Health Carolinas Medical Center, Charlotte, NC USA
| | - William C. Faquin
- Department of Pathology, Massachusetts General Hospital, Boston, MA USA ,Massachusetts Eye and Ear Infirmary, Boston, MA USA
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Wu B, Lim CM, Petersson F. Primary Tonsillar Epithelioid Follicular Dendritic Cell Sarcoma: Report of a Rare Case Mimicking Undifferentiated Carcinoma and a Brief Review of the Literature. Head Neck Pathol 2019; 13:606-612. [PMID: 30758753 PMCID: PMC6854199 DOI: 10.1007/s12105-019-01015-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
Abstract
We present a 52 years old male with a left tonsillar follicular dendritic cell sarcoma with prominent epithelioid features that on light microscopical examination bore a striking resemblance to a lymphoepithelial or undifferentiated carcinoma. The tumor was immunohistochemically positive for CD21 and CD35 and negative for cytokeratins. Two distinct histopathological features (both present in our case) that may serve as clues to the correct diagnosis on light microscopical examination were formation of ectatic pseudovascular spaces lined by malignant cells and the presence of non-neoplastic multinucleated giant cells. Familiarity with the above-mentioned morphological clues, and awareness that this tumour may occur in anatomical sites outside the lymph node, are essential for accurate diagnosis.
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Affiliation(s)
- Bingcheng Wu
- grid.410759.e0000 0004 0451 6143Department of Pathology, National University Health System, 5 Lower Kent Ridge Road, Singapore, 119074 Singapore
| | - Chwee Ming Lim
- grid.410759.e0000 0004 0451 6143Department of Otolaryngology, National University Health System, Singapore, Singapore
| | - Fredrik Petersson
- grid.410759.e0000 0004 0451 6143Department of Pathology, National University Health System, 5 Lower Kent Ridge Road, Singapore, 119074 Singapore
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7
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Wang L, Xu D, Qiao Z, Shen L, Dai H, Ji Y. Follicular dendritic cell sarcoma of the spleen: A case report and review of the literature. Oncol Lett 2016; 12:2062-2064. [PMID: 27602139 DOI: 10.3892/ol.2016.4826] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 06/16/2016] [Indexed: 12/27/2022] Open
Abstract
Follicular dendritic cell sarcoma (FDCS), which originates in antigen-presenting cells of the B-cell follicles of the lymph nodes, is an uncommon disease, particularly in a splenic location. In a number of cases, FDCS may easily be confused with other solid tumors and be underdiagnosed. The present study reports a case in which such as tumor occurred in a 64-year-old woman. The patient presented with an abdominal mass, and computed tomography was performed. Histological and immunohistochemical studies revealed a diagnosis of FDCS. The patient underwent surgical treatment and had a good remission. At the time of writing, the patient was in good condition. The present study also discusses the clinical characteristics, treatment methods and prognosis of FDCS, with particular reference to the main points of the imaging diagnosis.
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Affiliation(s)
- Lifeng Wang
- Department of Radiology, Affiliated Wujiang Hospital of Nantong University, Suzhou, Jiangsu 215200, P.R. China
| | - Dongfeng Xu
- Department of Radiology, Affiliated Wujiang Hospital of Nantong University, Suzhou, Jiangsu 215200, P.R. China
| | - Zhenguo Qiao
- Department of Gastroenterology, Affiliated Wujiang Hospital of Nantong University, Suzhou, Jiangsu 215200, P.R. China
| | - Li Shen
- Department of Radiology, Affiliated Wujiang Hospital of Nantong University, Suzhou, Jiangsu 215200, P.R. China
| | - Hongzhi Dai
- Department of Radiology, Affiliated Wujiang Hospital of Nantong University, Suzhou, Jiangsu 215200, P.R. China
| | - Yiding Ji
- Department of Radiology, Affiliated Wujiang Hospital of Nantong University, Suzhou, Jiangsu 215200, P.R. China
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8
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Pang J, Mydlarz WK, Gooi Z, Waters KM, Bishop J, Sciubba JJ, Kim YJ, Fakhry C. Follicular dendritic cell sarcoma of the head and neck: Case report, literature review, and pooled analysis of 97 cases. Head Neck 2015; 38 Suppl 1:E2241-9. [PMID: 25917851 DOI: 10.1002/hed.24115] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Follicular dendritic cell sarcoma (FDCS) is a rare lymphoid neoplasm presenting in the head and neck. There are no pooled analyses of head and neck FDCS cases in the English language literature. METHODS A MEDLINE and PubMed review of cases from 1978 to February 2014 was performed. Demographics, clinicopathologic data, and outcomes were summarized. RESULTS We presented 2 patients and analyzed 97 cases. The mean age was 42.7 years (SD = 16.3 years). Outcomes were available for 76 patients. Tumors ≤4 cm had better disease-free survival (63% vs 28% at 5 years; p = .0282). Locoregional recurrence was significantly less likely with surgery and radiation compared to surgery alone (15% vs 45%; p = .019) and in patients receiving a neck dissection (10% vs 43%; p = .046). CONCLUSION This pooled analysis provides the largest sample size of FDCS of the head and neck to date and suggests that radiation and neck dissection may be beneficial to locoregional oncologic control. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2241-E2249, 2016.
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Affiliation(s)
- John Pang
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Wojciech K Mydlarz
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Zhen Gooi
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Kevin M Waters
- Department of Pathology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Justin Bishop
- Department of Pathology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
| | - James J Sciubba
- Milton J. Dance Jr. Head and Neck Cancer Center, Johns Hopkins Head and Neck Surgery, Baltimore, Maryland
| | - Young J Kim
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Carole Fakhry
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland.,Milton J. Dance Jr. Head and Neck Cancer Center, Johns Hopkins Head and Neck Surgery, Baltimore, Maryland
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9
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Li J, Zhou ML, Zhou SH. Clinical and pathological features of head and neck follicular dendritic cell sarcoma. Hematology 2015; 20:571-83. [PMID: 25831474 DOI: 10.1179/1607845415y.0000000008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Ji Li
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003 Zhejiang Province, China
- Department of Otolaryngology, The First people's Hospital of Ningbo City, 315010 Zhejiang Province, China
| | - Min-Li Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003 Zhejiang Province, China
| | - Shui-Hong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003 Zhejiang Province, China
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Bushan K. Follicular Dendritic Cell Sarcoma Mediastinum - a case report. Indian J Surg Oncol 2014; 5:290-2. [PMID: 25767341 PMCID: PMC4354835 DOI: 10.1007/s13193-014-0349-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 08/27/2014] [Indexed: 10/24/2022] Open
Abstract
Follicular dendritic cell tumor (FDCT) are extremely rare difficult to diagnose category tumors.There has been a considerable controversy in medical community regarding precise classification and optimal management of this tumor with some treating it as a form of non Hodgkins lymphoma and some as soft tissue sarcomas.The number of published cases are still low and documentation too heterogenous to give statistically ified therapeutic recommendation of these tumors.This case report aims to highlight various aspects of diagnosing and treating this rare entity.
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Affiliation(s)
- Kirti Bushan
- Department of surgical oncology, Asian institute of oncology Mumbai, Somaiya, Sion, Mumbai, Maharashtra 400022 India
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11
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Vorsprach M, Kalinski T, Vorwerk U. Follicular dendritic cell sarcoma of the tonsil. Pathol Res Pract 2014; 211:88-91. [PMID: 25512260 DOI: 10.1016/j.prp.2014.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 08/08/2014] [Accepted: 09/16/2014] [Indexed: 10/24/2022]
Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm that occurs extranodally and nodally. The following case report describes a 24-year-old male patient who suffered from FDCS of the tonsil. He presented at the ENT Department of the University Hospital Magdeburg with throat pain that had lasted for 3 months. There were neither B symptoms nor abnormal fatigue. An extended tonsillectomy was performed. The morphological and immunohistochemical findings confirmed the diagnosis of FDCS. FDCS should be considered as an important differential diagnosis in spindle cell tumors of the tonsil.
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Affiliation(s)
- Monique Vorsprach
- Department of Pneumology, Otto-von-Guericke University, Magdeburg, Germany.
| | - Thomas Kalinski
- Department of Pathology, Otto-von-Guericke University, Magdeburg, Germany
| | - Ulrich Vorwerk
- Department of Otorhinolaryngology, Otto-von-Guericke University, Magdeburg, Germany
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12
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Lu ZJ, Li J, Zhou SH, Dai LB, Yan SX, Wu TT, Bao YY. Follicular dendritic cell sarcoma of the right tonsil: A case report and literature review. Oncol Lett 2014; 9:575-582. [PMID: 25621026 PMCID: PMC4301502 DOI: 10.3892/ol.2014.2726] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 11/07/2014] [Indexed: 12/13/2022] Open
Abstract
The current study presents a case of extranodal follicular dendritic cell sarcoma (FDCS) of the tonsil and reviews the relevant literature. In the present case, a 59-year-old male presented with a globus sensation in the right pharynx for 6 weeks. On clinical examination, a painless non-ulcerated enlarged right tonsil was identified; the tonsil was covered with a normal mucus membrane. A right tonsillectomy was performed under general anesthesia. The final pathological diagnosis was follicular dendritic cell sarcoma of the right tonsil. Postoperatively, the patient received radiotherapy. The patient remains alive without disease recurrence or metastasis 44 months after tonsillectomy. To the best of our knowledge, only 42 cases of FDCS of the tonsil have been reported to date. Of the 42 cases, 41 patients underwent surgery and one patient refused treatment. A total of 23 (54.7%) received surgery alone. Adjuvant treatment was administered for 18 patients (42.9%). Six patients (14.3%) experienced local recurrences and two patients (4.8%) succumbed to the disease 24 months after treatment. The three-, five-, and eight-year overall survival rates for the entire group were 86.5, 77.8 and 77.8%, respectively. Furthermore, a tumor diameter of ≥4 cm was prognostic upon univariate analysis (χ2=4.634; P=0.031; excluding incomplete data). Tonsillar FDCS is rare and is associated with high rates of recurrence and metastasis, therefore, adjuvant treatment should be prescribed.
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Affiliation(s)
- Zhong-Jie Lu
- Department of Radiotherapy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Ji Li
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Shui-Hong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Li-Bo Dai
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Sen-Xiang Yan
- Department of Radiotherapy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Ting-Ting Wu
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Yang-Yang Bao
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
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13
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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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14
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Al-Hussain T, Saleem M, Velagapudi SB, Dababo MA. Follicular dendritic cell sarcoma of parapharyngeal space: a case report and review of the literature. Head Neck Pathol 2014; 9:135-9. [PMID: 24668593 PMCID: PMC4382470 DOI: 10.1007/s12105-014-0537-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 03/19/2014] [Indexed: 12/29/2022]
Abstract
Follicular dendritic cell sarcoma (FDCS) of the parapharyngeal space is a rare malignant tumor. Only eleven cases of FDCS of the parapharyngeal space have been reported in English literature. Most of the reported cases developed tumor recurrence within 1 year or had metastasis. Because of the rarity of FDCS in the parapharyngeal space and peculiar histology, it can be misdiagnosed as undifferentiated carcinoma or meningioma. Therefore, pathologists should be aware of the existence of FDCS in this location. This paper aims to report a unique case of FDCS of the parapharyngeal space without recurrence in 26 months follow up with a review of the literature.
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Affiliation(s)
- Turki Al-Hussain
- />Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Muhammad Saleem
- />Department of Otolaryngology, Head and Neck Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Suresh Babu Velagapudi
- />Department of Otolaryngology, Head and Neck Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohammad Anas Dababo
- />Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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15
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Cerda T, Sun XS, Cazorla A, Laurent C, Floret F, Haudebourg J, Thyss A, Thariat J. [Follicular dendritic cell sarcoma in head and neck region]. Cancer Radiother 2014; 18:59-63. [PMID: 24373643 DOI: 10.1016/j.canrad.2013.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 10/14/2013] [Accepted: 10/22/2013] [Indexed: 10/25/2022]
Abstract
Follicular dendritic cell sarcomas are a recently described entity, with biphenotypic characteristics of lymphomas and sarcomas. The treatment is hardly consensual in the literature. We report two head and neck cases, of favorable outcome after surgery and radiotherapy. Histopathology and differential diagnoses are discussed as well as the therapeutic strategies used.
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Affiliation(s)
- T Cerda
- Département de radiothérapie, centre hospitalier régional universitaire de Besançon, hôpital Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France; Département de radiothérapie, centre hospitalier de Belfort-Montbéliard, boulevard du Maréchal-Juin, 25209 Montbéliard cedex, France
| | - X S Sun
- Département de radiothérapie, centre hospitalier régional universitaire de Besançon, hôpital Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France; Département de radiothérapie, centre hospitalier de Belfort-Montbéliard, boulevard du Maréchal-Juin, 25209 Montbéliard cedex, France.
| | - A Cazorla
- Service d'anatomopathologie, centre hospitalier régional universitaire de Besançon, hôpital Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France
| | - C Laurent
- Laboratoire d'anatomie et cytologie pathologiques, CHU Purpan, place du Dr-Baylac, 31059 Toulouse, France; Université Paul-Sabatier, 31062 Toulouse cedex 9, France
| | - F Floret
- Service d'ORL, centre hospitalier régional universitaire de Besançon, hôpital Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France
| | - J Haudebourg
- Service d'anatomie et cytologie pathologiques, centre Antoine-Lacassagne, institut universitaire de la face et du cou, université de Nice-Sophia-Antipolis, 33, avenue Valombrose, 06189 Nice, France
| | - A Thyss
- Service d'oncologie médicale, centre Antoine-Lacassagne, institut universitaire de la face et du cou, université de Nice-Sophia-Antipolis, 33, avenue Valombrose, 06189 Nice, France
| | - J Thariat
- Département de radiothérapie, centre Antoine-Lacassagne, institut universitaire de la face et du cou, université de Nice-Sophia-Antipolis, 33, avenue Valombrose, 06189 Nice, France
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16
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Abstract
Follicular dendritic cells (FDCs) are non-phagocytic, non-lymphoid cells of immune system, which are necessary for antigen presentation and regulation of the reactions in the germinal centers of lymph node. Follicular dendritic cell sarcoma (FDCS) is unusual and those with an extranodal origin in the head and neck region are extremely rare. Here, we report a case of FDCS of the left tonsil in a 27-year-old male patient. The patient presented with swelling of the left tonsil and resultant difficulty in swallowing for last three months. The tumor was excised and was sent for histopathologic examination. Microscopic examination and immunohistochemical analysis proved the case to be FDCS. After the diagnosis, the patient received post-operative radiotherapy. The patient is on six months follow-up which is uneventful.
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Affiliation(s)
- Santosh Kumar Mondal
- Department of Pathology, Medical College, 88 College Street, Kolkata, West Bengal, India
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17
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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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18
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Hu T, Wang X, Yu C, Yan J, Zhang X, Li L, Li X, Zhang L, Wu J, Ma W, Li W, Wang G, Zhao W, Gao X, Zhang D, Zhang M. Follicular dendritic cell sarcoma of the pharyngeal region. Oncol Lett 2013; 5:1467-1476. [PMID: 23761812 PMCID: PMC3678726 DOI: 10.3892/ol.2013.1224] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 02/04/2013] [Indexed: 12/12/2022] Open
Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm arising most commonly from follicular dendritic cells in the lymph nodes. It is exceedingly rare in extranodal sites, particularly in the pharyngeal region. The present study reports 3 cases occurring in the pharyngeal region. Case 1 had tonsil and cervical lymph node involvement, while case 3 also had tonsil involvement. Cases 1 and 3 relapsed locally at 3 and 17 months after surgery, respectively. Case 2 was diagnosed with a tumor in the parapharyngeal space and the patient succumbed to the disease 5 months after treatment with combined surgery and chemotherapy. All 3 cases were misdiagnosed initially. Pathological biopsy examination, including histopathology and immunohistochemistry, was essential for diagnosis. The data for 52 cases, including cases from the literature and the present cases, were analyzed. The results indicated that 57% (26/46) of the initial diagnoses were inaccurate, while the recurrence, metastasis and mortality rates were 40, 16 and 10%, respectively. The statistics supported the theory that FDCS of the pharyngeal region is a low-grade sarcoma. Involvement of the tonsils (52%, 27/52) and parapharyngeal space (19%, 10/52) were observed most commonly, while FDCS at various sites showed different prognoses. The various survival rates were calculated in the present study. The large tumors (≥4 cm) had a poorer prognosis than the small tumors (<4 cm; P<0.05). Among the 50 cases with available follow-up data, 46% (23/50) were treated with surgery alone, 52% (26/50) with combination therapy (surgery followed by chemotherapy and/or radiotherapy) and 2% (1/50) with surveillance. There was no statistically significant evidence (P>0.05) that combination therapy improves survival rates, compared with surgery alone.
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Affiliation(s)
- Tengpeng Hu
- Lymphoma Diagnosis and Treatment Center, Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
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19
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Radović S, Dorić M, Zujo H, Hukić A, Kuskunović S, Babić M, Tomić I. Interdigitating dendritic cell sarcoma of the liver and lung: a case report with morphohological and immunohistochemical features of tumor. Bosn J Basic Med Sci 2013; 12:203-6. [PMID: 22938549 DOI: 10.17305/bjbms.2012.2485] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Interdigitating dendritic cell sarcoma is extremely rare neoplasm that mainly occurs in the lymph nodes. Only 45 cases have been reported in the literature to date. We report a case of this sarcoma arising from the liver and lung, a previosly unreported site for this neoplasm. An 19-year-old girl deteriorated rapidly after artificial abortion and died 4 weeks later. Autopsy showed markedly enlarged liver and lung with numerous nodules up to 0.5 centimeters in diameter. Microscopically, nodules was composed of large pleomorphic cells that were immunohistochemically positive for proteins S-100 and vimentin, some of them expressed positivity to fascin and CD 68, with a rich small CD3 positive T lymphocytic infiltrateite around them. Based of these findings, the present case was diagnosed as interdigitating dendritic cell sarcoma, a neoplasm that remains a diagnostic and clinical challenge, because it can mimic a wide variety of other malignant tumors and tumor-like lesions.
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Affiliation(s)
- Svjetlana Radović
- Institute of Pathology, University of Sarajevo, Čekaluša, Sarajevo, Bosnia and Herzegovina.
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20
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Pyo JS, Kang G, Do SI, Chae SW, Kim K, Lee SH, Choi YL, Choi JH, Sohn JH, Kim DH. Extranodal follicular dendritic cell sarcoma with rapid growth in parapharynx: a case report. KOREAN JOURNAL OF PATHOLOGY 2012; 46:306-10. [PMID: 23110021 PMCID: PMC3479760 DOI: 10.4132/koreanjpathol.2012.46.3.306] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Revised: 03/28/2012] [Accepted: 03/29/2012] [Indexed: 11/17/2022]
Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare malignancy arising from the antigen-presenting cells in the lymph node and extranodal tissue. We describe a 31-year-old male patient who presented with a swelling of the left parapharynx. The radiologic findings showed a 4.7×4.5×1.9 cm-sized, ill-defined mass in the left parapharyngeal space. A fine-needle aspiration cytology was performed and it showed scattered, irregular, cohesive clusters of tumor cells with a spindle-to-ovoid shape with irregular contours in a background of lymphocytes. Based on these findings, a diagnosis of spindle cell neoplasm was made. The surgically resected tumor was composed of elongated, ovoid or polygonal cells showing positive immunohistochemistry for CD21, CD23, and CD35. Postoperatively, the residual tumor was observed to undergo a rapidly growth. There is an overlap in the cytologic and histologic findings between FDCS of the parapharynx and other tumors. Pathologists should therefore be aware of its characteristics not only to provide an accurate diagnosis but also to recommend the appropriate clinical management.
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Affiliation(s)
- Jung-Soo Pyo
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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21
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Karabulut B, Orhan K, Guldiken Y, Dogan O. Follicular dendritic cell sarcoma of the nasopharynx. Int J Oral Maxillofac Surg 2012; 41:218-20. [DOI: 10.1016/j.ijom.2011.06.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 06/02/2011] [Accepted: 06/24/2011] [Indexed: 10/17/2022]
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22
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Abstract
Follicular dendritic cell sarcoma (FDCS) is unusual, and those with an extranodal origin in the head and neck region are extremely rare. To date, no cases of tumors featuring the characteristics of follicular dendritic cells were reported in Korea. We report a new case of FDCS of the tonsils in a 65-year-old man. A diagnostic tonsillectomy was performed. Based on histopathologic and immunohistochemical findings, the patient was diagnosed with FDCS. Adjuvant radiotherapy was performed due to a high mitotic count. The patient survived with a 2-year disease free period. The differential diagnosis of a tonsillar mass must include FDCS. In cases in which FDCS is suspected on histopathologic examination, an immunohistochemical study is essential for the diagnosis.
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Affiliation(s)
- Young Gyu Eun
- Department of Otolaryngology-Head and Neck Surgery, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea
| | - Sung Wan Kim
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Kee Hwan Kwon
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
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23
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Duan GJ, Wu F, Zhu J, Guo DY, Zhang R, Shen LL, Wang SH, Li Q, Xiao HL, Mou JH, Yan XC. Extranodal follicular dendritic cell sarcoma of the pharyngeal region: a potential diagnostic pitfall, with literature review. Am J Clin Pathol 2010; 133:49-58. [PMID: 20023258 DOI: 10.1309/ajcp7u8yisbuavnw] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Extranodal follicular dendritic cell sarcoma (FDCS) of the pharyngeal region is a rare malignant tumor recognized in recent years, with approximately 37 cases so far reported in the literature. It is often not considered at the initial evaluation and may be misdiagnosed in a small biopsy specimen. We report 4 cases of extranodal FDCS, 2 cases in the nasopharynx that were diagnosed as undifferentiated carcinomas because they were characterized by syncytial epithelial cells with sheet or nest-like distribution and 2 cases in the tonsil and soft palate that were characterized by vaguely concentric whorls consisting of spindle to ovoid cells. The latter case was diagnosed as ectopic meningioma. The analysis of all cases from the literature and ours shows that 58% (21/36) of the cases are misdiagnosed initially, often as undifferentiated carcinoma or meningioma, which the differential diagnoses should be mostly focused on. With a median follow-up of 27 months, the recurrence, metastasis, and mortality rates are 23%, 21%, and 3%, respectively, suggesting that extranodal FDCS of the pharyngeal region remains a low-grade sarcoma. Radical surgery is recommended, whereas there is no evidence to support adjuvant therapy.
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24
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Vaideeswar P, George SM, Kane SV, Chaturvedi RA, Pandit SP. Extranodal follicular dendritic cell sarcoma of the tonsil – Case report of an epithelioid cell variant with osteoclastic giant cells. Pathol Res Pract 2009; 205:149-53. [DOI: 10.1016/j.prp.2008.07.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2008] [Revised: 07/09/2008] [Accepted: 07/25/2008] [Indexed: 01/11/2023]
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25
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Chera BS, Orlando C, Villaret DB, Mendenhall WM. Follicular Dendritic Cell Sarcoma of the Head and Neck: Case Report and Literature Review. Laryngoscope 2008; 118:1607-12. [DOI: 10.1097/mlg.0b013e31817aec58] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Encabo RS, McHugh J, Carrau RL, Kassam A, Heron D. Follicular dendritic cell sarcoma of the nasopharynx. Am J Otolaryngol 2008; 29:262-4. [PMID: 18598838 DOI: 10.1016/j.amjoto.2007.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Accepted: 08/20/2007] [Indexed: 11/17/2022]
Abstract
Follicular dendritic cell (FDC) sarcoma is an extremely rare malignant neoplasm that can develop in the head and neck in both lymph nodes and extranodal sites. Only 4 cases of FDC tumor of the nasopharynx have been published before. Because of its rarity, FDC sarcoma is not easily recognized by clinicians or pathologists. We present the case of a FDC tumor of the nasopharynx in a 36-year-old woman.
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Affiliation(s)
- Rosalía Souvirón Encabo
- Department of Otolaryngology and Head and Neck Surgery, "Gregorio Marañón" University General Hospital, Madrid, Spain
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27
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Kairouz S, Hashash J, Kabbara W, McHayleh W, Tabbara IA. Dendritic cell neoplasms: an overview. Am J Hematol 2007; 82:924-8. [PMID: 17636477 DOI: 10.1002/ajh.20857] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Dendritic cell neoplasms are rare tumors that are being recognized with increasing frequency. They were previously classified as lymphomas, sarcomas, or histiocytic neoplasms. The World Health Organization (WHO) classifies dendritic cell neoplasms into five groups: Langerhans' cell histiocytosis, Langerhans' cell sarcoma, Interdigitating dendritic cell sarcoma/tumor, Follicular dendritic cell sarcoma/tumor, and Dendritic cell sarcoma, not specified otherwise (Jaffe, World Health Organization classification of tumors 2001; 273-289). Recently, Pileri et al. provided a comprehensive immunohistochemical classification of histiocytic and dendritic cell tumors (Pileri et al., Histopathology 2002;59:161-167). In this article, a concise overview regarding the pathological, clinical, and therapeutic aspects of follicular dendritic, interdigitating dendritic, and Langerhans' cell tumors is presented.
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Affiliation(s)
- Sebastien Kairouz
- Department of Internal Medicine, Division of Hematology/Oncology, The George Washington University Medical Center, Washington, DC 20037, USA
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28
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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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29
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Aydin E, Ozluoglu LN, Demirhan B, Arikan U. Follicular dendritic cell sarcoma of the tonsil: case report. Eur Arch Otorhinolaryngol 2006; 263:1155-7. [PMID: 16896752 DOI: 10.1007/s00405-006-0124-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2005] [Accepted: 06/28/2006] [Indexed: 11/30/2022]
Abstract
Follicular dendritic cell sarcomas are unusual, and extranodal origin is extremely rare. The English literature contains only eight cases in which this sarcoma has been presented as a tonsillar mass. We report a new case of follicular dendritic cell sarcoma of the tonsil in a 76 year old woman. The patient underwent diagnostic tonsillectomy for a left tonsillar mass, and follicular dendritic cell sarcoma was diagnosed based on histopathological and immunoperoxidase findings. Postoperative radiotherapy was performed. The patient is alive and disease-free at 4 years of follow-up. Without a high index of suspicion, this entity can easily be missed. We believe that follicular dendritic cell sarcoma should be included in the differential diagnosis for any tonsillar mass.
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Affiliation(s)
- Erdinc Aydin
- Faculty of Medicine, Department of Otorhinolaryngology & Head and Neck Surgery, Baskent University, 6. Cadde No: 72/2, 06490 Bahcelievler-Ankara, Turkey.
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30
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Clement P, Saint-Blancard P, Minvielle F, Le Page P, Kossowski M. Follicular dendritic cell sarcoma of the tonsil: a case report. Am J Otolaryngol 2006; 27:207-10. [PMID: 16647987 DOI: 10.1016/j.amjoto.2005.09.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2005] [Indexed: 11/26/2022]
Abstract
Follicular dendritic cell sarcomas of the tonsil are very rare tumors. Only 10 cases have been published in the English-language medical literature. We present an additional case that occurred in a 27-year-old woman. She presented with a tumor of the right tonsil. Histological sections of tonsillar biopsies and tonsillectomy suggested that this tumor was a nerve sheath tumor or a malignant melanoma. Histological examination and immunohistochemical study were reviewed. The final diagnosis was follicular dendritic cell sarcoma. She underwent a transoral resection of the right oropharynx with ipsilateral selective neck dissection and postoperative irradiation. We emphasize the difficulties in diagnosing this type of tumor. The use of monoclonal specific markers is required to avoid misdiagnosis. We discuss therapeutic methods for this rare tumor for which optimal treatment has not yet been defined.
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Affiliation(s)
- Philippe Clement
- Department of Otorhinolaryngology-Head and Neck Surgery, Hôpital d'Instruction des Armées Percy, Clamart, France.
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