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Li Y, Yang X, Tao L, Zeng W, Zuo M, Li S, Wu L, Lin Y, Zhang Z, Yun J, Huang Y. Challenges in the Diagnosis of Epstein-Barr Virus-positive Inflammatory Follicular Dendritic Cell Sarcoma: Extremely Wide Morphologic Spectrum and Immunophenotype. Am J Surg Pathol 2023; 47:476-489. [PMID: 36574358 DOI: 10.1097/pas.0000000000002011] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Epstein-Barr virus (EBV)-positive inflammatory follicular dendritic cell (FDC) sarcoma (EBV + IFDCS) is a rare entity, and its histopathological characteristics have not been fully described. Here, we investigated the wide morphologic spectrum and immunophenotype of this tumor with the aim to help avoid misdiagnosis. Thirteen cases of EBV + IFDCS were retrospectively analyzed, combined with a review of 70 cases reported in the literature. The median age of patients was 49 (range, 29 to 67 y). Six patients were male and 7 were female. Most cases (92.3%, 12/13) occurred in the liver or spleen, and only 1 case affected an extra-hepatosplenic site (lung, 7.7%, 1/13). Tumors were assessed for a variety of histologic features and assigned to the following morphologic groups: classic type (53.8%, 7/13), lymphoma-like subtype (38.5%, 5/13), and hemangioma-like subtype (7.7%, 1/13). The classic type had distinct EBV-positive neoplastic cells with a fascicular or storiform growth pattern, variable lymphoplasmacytic infiltrates, and blood vessels. The lymphoma-like subtype had extremely prominent lymphoplasmacytic infiltrates (resembling marginal zone lymphoma with plasmacytoid differentiation) with singly dispersed distinct EBV-positive neoplastic cells, highlighted by in situ hybridization for EBV-encoded small RNA. The hemangioma-like subtype had extremely prominent blood vessels with hyaline and/or fibrinoid degeneration, singly dispersed distinct EBV-positive neoplastic cells, and limited lymphoplasmacytic infiltrates. Immunohistochemically, the neoplastic cells showed variable staining for FDC markers (CD21, CD35, CD23, and SSTR2) and the fibroblastic marker SMA, with the staining ranging from very focal to extensive. The number of EBV-positive neoplastic cells ranged from 80 to 400/HPF. All cases showed variable expression of PD-ligand 1 (PD-L1) (CPS: 5-90). IgG4-positive cells ranged from rare up to 100/HPF. Interestingly, 2 cases satisfied the criteria proposed in a previous study, mimicking IgG4-related disease. EBV + IFDCS is an entity with an extremely wide morphologic spectrum and immunophenotype. Awareness of the spectrum of morphologic presentations of this rare tumor, specifically the lymphoma-like subtype and hemangioma-like subtype, is important for accurate diagnosis.
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Affiliation(s)
- Yan Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
| | - Xia Yang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
| | - Lili Tao
- Department of Pathology, Peking University Shenzhen Hospital
| | - Weimei Zeng
- Guangdong No. 2 Provincial People's Hospital, Guangzhou, Guangdong
| | - Min Zuo
- Department of Pathology, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Shuo Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
| | - Liyan Wu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
| | - Yanshong Lin
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
| | - Ziying Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
| | - Jingping Yun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
| | - Yuhua Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
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Ding F, Wang C, Xu C, Tang H. Case report: Hepatic inflammatory pseudotumor-like follicular dendritic cell sarcoma: A rare case and minireview of the literature. Front Med (Lausanne) 2022; 9:1002324. [PMID: 36425103 PMCID: PMC9679012 DOI: 10.3389/fmed.2022.1002324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
Inflammatory pseudotumor (IPT)-like follicular dendritic cell sarcoma (FDCS) is a rare neoplasm referred to as the FDCS variant. Here we report a 66-year-old female patient suffering from hepatic IPT-like FDCS and summarize IPT-like FDCS reported in the literature. The patient presented with obvious abdominal pain without significant laboratory abnormalities and subsequently underwent surgical resection of a hepatic lesion. Postoperative pathological results demonstrated a vascular tissue-rich neoplasm (7.0-cm maximum diameter). The tumor cells expressed CD21 and CD35, and in situ hybridization detected Epstein–Barr virus-encoded RNA (EBER). Metastasis or recurrence was not detected during the 7-year follow-up.
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Affiliation(s)
- Fan Ding
- Center of Gallbladder Disease, East Hospital of Tongji University, Shanghai, China
- Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China
| | - Chao Wang
- Department of Radiology, Nanxiang Hospital of Jiading District, Shanghai, China
| | - Chi Xu
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Organ Transplantation Institute, Sun Yat-sen University, Guangzhou, China
- Chi Xu,
| | - Hui Tang
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Organ Transplantation Institute, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Hui Tang,
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3
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Nguyen A, Negrete LM, Bulterys PL, Shen L. Inflammatory pseudotumor-like follicular dendritic cell tumor of the spleen: a case report and approach to differential diagnosis. Radiol Case Rep 2021; 16:3213-3216. [PMID: 34484521 PMCID: PMC8405940 DOI: 10.1016/j.radcr.2021.07.078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/19/2021] [Accepted: 07/24/2021] [Indexed: 11/17/2022] Open
Abstract
We present a case of an inflammatory pseudotumor-like follicular dendritic cell tumor of the spleen. The patient is a 44-year-old woman, without significant underlying history, who presented with nonspecific abdominal pain for a few months. Both a contrast enhanced computed tomography and magnetic resonance imaging revealed a new 2.5 cm enhancing splenic lesion, which demonstrated hypermetabolic activity on subsequent positron emission tomography and computed tomography scan. Since the lesion was new compared to more remote imaging and hypermetabolic, a splenectomy was performed. Pathology confirmed the diagnosis and demonstrated positivity for Epstein-Barr Virus .
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Affiliation(s)
- Andrew Nguyen
- Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | - Lindsey M Negrete
- Body Imaging Division, Department of Radiology, Stanford University, 300 Pasteur Drive, H1307, Stanford, CA 94305, USA
| | | | - Luyao Shen
- Body Imaging Division, Department of Radiology, Stanford University, 300 Pasteur Drive, H1307, Stanford, CA 94305, USA
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Pascariu AD, Neagu AI, Neagu AV, Băjenaru A, Bețianu CI. Hepatic inflammatory pseudotumor-like follicular dendritic cell tumor: a case report. J Med Case Rep 2021; 15:410. [PMID: 34321082 PMCID: PMC8320187 DOI: 10.1186/s13256-021-02957-5] [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: 10/06/2020] [Accepted: 06/14/2021] [Indexed: 11/29/2022] Open
Abstract
Background Inflammatory pseudotumor-like follicular dendritic cell sarcoma is a rare histological variant of follicular dendritic cell sarcoma involving typically the spleen and the liver, often linked to the presence of Epstein–Barr virus infection. Definite diagnosis of this type of sarcoma is difficult to make owing to nonspecific clinical and imaging findings and is based on histopathological features. Inflammatory pseudotumor-like follicular dendritic cell sarcoma is described as a low-aggressivity tumor with a favorable prognosis. Case presentation We report the case of a 34-year-old Caucasian woman, Epstein–Barr virus positive, diagnosed with hepatic inflammatory pseudotumor-like follicular dendritic cell sarcoma and surgically treated in November 2014, who developed 6 years later a recurrence for which she underwent once again surgical treatment. As far as we know, fewer than 30 reports of inflammatory pseudotumor-like follicular dendritic cell liver tumors have been reported in the English literature. Conclusions Although it is an uncommon tumor, inflammatory pseudotumor-like sarcoma is a diagnostic worth being taken in consideration, and surveillance is recommended owing to the possibility of recurrence.
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Affiliation(s)
- Ana Daniela Pascariu
- Department of Radiology, "Carol Davila" Central Military Emergency University Hospital, Mircea Vulcanescu Street, no. 88, 010825, Bucharest, Romania
| | - Andreea Ioana Neagu
- Department of Radiology, "Carol Davila" Central Military Emergency University Hospital, Mircea Vulcanescu Street, no. 88, 010825, Bucharest, Romania
| | - Andrei Valentin Neagu
- Department of Radiology, "Carol Davila" Central Military Emergency University Hospital, Mircea Vulcanescu Street, no. 88, 010825, Bucharest, Romania
| | - Alexandru Băjenaru
- Department of Radiology, "Carol Davila" Central Military Emergency University Hospital, Mircea Vulcanescu Street, no. 88, 010825, Bucharest, Romania
| | - Cezar Iulian Bețianu
- Department of Interventional Radiology, "Carol Davila" Central Military Emergency University Hospital, Mircea Vulcanescu Street, no.88, 010825, Bucharest, Romania.
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5
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Wu H, Liu P, Xie XR, Chi JS, Li H, Xu CX. Inflammatory pseudotumor-like follicular dendritic cell sarcoma: Literature review of 67 cases. World J Meta-Anal 2021; 9:1-11. [DOI: 10.13105/wjma.v9.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/02/2021] [Accepted: 02/24/2021] [Indexed: 02/06/2023] Open
Abstract
Inflammatory pseudotumor (IPT)-like follicular dendritic cell (FDC) sarcoma is rare. The 2017 World Health Organization classification of tumors of hematopoietic and lymphoid tissues noted that data on its clinical outcome are limited, but that the tumor appears to be indolent. The aim of this study was to summarize the clinical characteristics, treatment outcomes, and prognostic factors for IPT-like FDC sarcoma. A literature review was conducted on retrospective analyses of clinical data and prognostic information on IPT-like FDC sarcoma reported between 2001 and 2020. A total of 67 cases of IPT-like FDC sarcoma were retrieved from the literature, documenting that it occurs predominantly in middle-aged adults, with a marked female predilection. Six patients had a separate malignancy and five had an autoimmune disease. Typically involving the spleen and/or liver, it may also selectively involve the abdomen, gastrointes-tinal tract, pancreas, retroperitoneum, and mesentery. Necrosis, hemorrhage, noncaseating epithelioid granulomas, and fibrinoid deposits in blood vessel walls are often present. The neoplastic cells are predominantly positive for follicular dendritic cell markers such as cluster of differentiation 21 (CD21), CD23, CD35 and CNA.42 and are consistently Epstein-Barr virus (EBV)-positive. Mitoses were very rare in most cases. Most patients were treated by surgery alone. Disease status at the time of last follow-up was known for 57 patients with follow-up time ranging from 2 to 144 mo. Local and/or distant recurrence after initial treatment was seen in 15.8% of the patients. The 1- and 5-year progression-free survival for the entire group was 91.5% and 56.1%, respectively. Kaplan-Meier and multivariate analyses showed that age, sex, tumor size, and pathological features were not risk factors for disease progression. IPT-like FDC sarcoma appears to be mildly aggressive and requires annual surveillance. Surgery is the most effective treatment modality, and the role of adjuvant chemotherapy for postoperative management is unclear. EBV is likely to play an important role in the etiology of IPT-like FDC sarcoma.
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Affiliation(s)
- Hao Wu
- Department of Gastroenterology, Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
| | - Peng Liu
- Department of Gastroenterology, Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
| | - Xiao-Ran Xie
- Department of Gastroenterology, Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
| | - Jing-Shu Chi
- Department of Gastroenterology, Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
| | - Huan Li
- Department of Gastroenterology, Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
| | - Can-Xia Xu
- Department of Gastroenterology, Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
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6
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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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7
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Morales-Vargas B, Deeb K, Peker D. Clinicopathologic and Molecular Analysis of Inflammatory Pseudotumor-Like Follicular/Fibroblastic Dendritic Cell Sarcoma: A Case Report and Review of Literature. Turk Patoloji Derg 2021; 37:266-272. [PMID: 34514557 PMCID: PMC10510619 DOI: 10.5146/tjpath.2021.01523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/24/2020] [Indexed: 11/18/2022] Open
Abstract
Inflammatory pseudotumor-like follicular/fibroblastic dendritic cell (FDC/FRC) sarcoma is an extremely rare neoplasm of the spleen associated with EBV and characterized by spindle cell morphology, dense mixed chronic inflammatory background, and a broad immunophenotypic profile often causing a diagnostic challenge for pathologists. The molecular features of FDC/FRC sarcoma are largely unknown due to a lack of comprehensive data. Here we present the results of next-generation sequencing and Single Nucleotide Polymorphism Copy Number array analysis in a case of FDC/FRC and review the literature.
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Affiliation(s)
- Bryan Morales-Vargas
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Georgia, USA
| | - Kristin Deeb
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Georgia, USA
| | - Deniz Peker
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Georgia, USA
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8
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Zhang BX, Chen ZH, Liu Y, Zeng YJ, Li YC. Inflammatory pseudotumor-like follicular dendritic cell sarcoma: A brief report of two cases. World J Gastrointest Oncol 2019; 11:1231-1239. [PMID: 31908727 PMCID: PMC6937438 DOI: 10.4251/wjgo.v11.i12.1231] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 09/19/2019] [Accepted: 09/26/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Follicular dendritic cell (FDC) sarcoma/tumor is a rare malignant tumor of follicular dendritic cells, which is considered a low-grade sarcoma that can involve lymph nodes or extranodal sites. Conventional FDC sarcomas are negative for Epstein-Barr virus (EBV), whereas the inflammatory pseudotumor-like variant consistently shows EBV in the neoplastic cells.
CASE SUMMARY We report two cases of inflammatory pseudotumor-like FDC sarcoma in the liver that received 3D laparoscopic right hepatectomy and open right hepatectomy separately.
CONCLUSION EBV probe-based in situ hybridization and detection of immunohistochemical markers of FDC play an important role in the diagnosis and differential diagnosis of inflammatory pseudotumor-like FDC sarcoma. Complete surgical excision combined with regional lymphadenectomy may be effective in reducing the postoperative recurrence and metastasis and improving long-term survival rates.
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Affiliation(s)
- Bi-Xi Zhang
- Department of Pathology, People’s Hospital of Hunan Province, Changsha 410005, Hunan Province, China
| | - Zhi-Hong Chen
- Department of Pathology, People’s Hospital of Hunan Province, Changsha 410005, Hunan Province, China
| | - Yu Liu
- Department of Pathology, People’s Hospital of Hunan Province, Changsha 410005, Hunan Province, China
| | - Yuan-Jun Zeng
- Department of Pathology, People’s Hospital of Hunan Province, Changsha 410005, Hunan Province, China
| | - Yan-Chun Li
- Department of Pathology, People’s Hospital of Hunan Province, Changsha 410005, Hunan Province, China
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9
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Deng S, Gao J. Inflammatory pseudotumor-like follicular dendritic cell sarcoma: a rare presentation of a hepatic mass. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2019; 12:3149-3155. [PMID: 31934158 PMCID: PMC6949706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 06/25/2019] [Indexed: 06/10/2023]
Abstract
Follicular dendritic cell (FDC) sarcoma is a rare, low-grade malignant tumor originating from follicular dendritic cells in germinal centers that accounts for 0.4% of all soft tissue sarcomas. FDC sarcoma is classified into two types, the classic FDC sarcoma and inflammatory pseudotumor (IPT)-like follicular dendritic cell (FDC) sarcoma, the latter of which is rarer. IPT-like FDC sarcoma mainly involves the spleen and liver with non-specific clinical and imaging manifestations. It is often misdiagnosed as an inflammatory disease such as a liver abscess or a malignant tumor such as hepatocellular carcinoma, with a pathological morphology similar to inflammatory pseudotumors. IPT-like FDC sarcoma mainly consists of a large number of inflammatory and round, oval and spindle cells with less pleomorphism. These tumor cells are arranged in a whorled, storiform, or sheet pattern. The immunophenotype of IPT-like FDC sarcoma is the same as that of FDC sarcoma and is positive for CD21, CD23, and CD35, and positive for EBER in situ hybridization (ISH). This disease is easily misdiagnosed because it is so rare that clinicians and pathologists may not consider it in diagnosis. Here, a case of IPT-like FDC sarcoma in the liver was reported, and the related literature was reviewed to summarize the clinicopathological features, treatment, and prognosis of this rare new type of FDC sarcoma, providing new knowledge of this rare neoplasm.
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Affiliation(s)
- Shuangshuang Deng
- Department of Pathology, Shanghai East Hospital, Tongji University School of Medicine Shanghai, China
| | - Jinli Gao
- Department of Pathology, Shanghai East Hospital, Tongji University School of Medicine Shanghai, China
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Inflammatory Pseudotumor-Like Follicular Dendritic Cell Sarcoma of the Spleen: Computed Tomography Imaging Characteristics in 5 Patients. J Comput Assist Tomogr 2018; 42:399-404. [PMID: 29287022 DOI: 10.1097/rct.0000000000000700] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The purpose of this study was to retrospectively review the computed tomography (CT) and clinicopathological characteristics of inflammatory pseudotumor (IPT)-like follicular dendritic cell sarcoma (FDCS) of the spleen in 5 patients. METHODS Clinical, pathologic, and CT imaging findings of 5 patients with IPT-like FDCS of the spleen were reviewed and analyzed. Computed tomography imaging and pathologic features were compared. RESULTS Abdominal unenhanced CT revealed a well-defined hypodense mass in the spleen with complex internal architecture with focal necrosis and/or speckle-strip calcification. On postcontrast CT, slightly delayed enhancement was observed in 5 cases. Four patients had a normalized spleen. The fourth patient had lung metastasis. The fifth patient had 2 relatively small lesions as well as metastases to the spine. CONCLUSIONS Computed tomography imaging features of IPT-like FDCS of the spleen are distinctly different from other hypovascular splenic neoplasm; however, the definitive diagnosis requires further confirmation with needle biopsy or surgery. Inflammatory pseudotumor-like FDCS of the spleen should be suggested by using the CT imaging features of the splenic mass with evidence of metastatic disease.
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Tregnago AC, Morbeck DL, D’Almeida Costa F, Campos AHJFM, Soares FA, Vassallo J. Inflammatory pseudotumor-like follicular dendritic cell tumor: an underdiagnosed neoplasia. ACTA ACUST UNITED AC 2017. [DOI: 10.1186/s41241-017-0051-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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12
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Van Baeten C, Van Dorpe J. Splenic Epstein-Barr Virus–Associated Inflammatory Pseudotumor. Arch Pathol Lab Med 2017; 141:722-727. [DOI: 10.5858/arpa.2016-0283-rs] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Splenic inflammatory pseudotumor (IPT) is an uncommon lesion with an inflammatory morphologic aspect that often poses a diagnostic challenge. The etiology of IPT can be infectious, autoimmune, reactive, or neoplastic. Splenic Epstein-Barr virus (EBV)–associated IPTs form a subset of splenic IPTs in which there is a spindle cell component infected by EBV. The best characterized and most frequent subgroup of splenic EBV-associated IPT is IPT-like follicular dendritic cell tumor. This review also focusses on EBV-associated splenic IPTs without follicular dendritic cell marker expression. These lesions are less well characterized, making the differential diagnosis with other splenic lesions even more difficult. Recently, increased numbers of immunoglobulin G4–positive plasma cells and the presence of numerous granulomas have been reported in EBV-associated IPTs, and this can add to the difficulties in recognizing the neoplastic nature of these lesions. Herein, we also review the epidemiology, clinical features, histologic morphology, immunohistochemistry, electron microscopy, and pathogenesis of EBV-associated IPTs.
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Affiliation(s)
| | - Jo Van Dorpe
- From the Department of Pathology, Ghent University Hospital, Ghent, Belgium
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13
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Chen Y, Shi H, Li H, Zhen T, Han A. Clinicopathological features of inflammatory pseudotumour-like follicular dendritic cell tumour of the abdomen. Histopathology 2015; 68:858-65. [PMID: 26332157 DOI: 10.1111/his.12851] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 08/26/2015] [Indexed: 01/16/2023]
Abstract
AIMS Inflammatory pseudotumour-like follicular dendritic cell (FDC) tumour is an extremely rare neoplasm. Herein, we report 10 cases of inflammatory pseudotumour-like FDC tumours in the abdomen and analyse their clinicopathological features. METHODS AND RESULTS Seven patients were male, and three patients were female. The patients' age ranged from 28 years to 68 years (mean age, 52.9 years; median age, 51.5 years). Grossly, the tumour was usually solitary, well circumscribed, and solid, ranging from 23 mm to 233 mm in greatest diameter. Microscopically, the tumour was composed of variable amounts of spindle tumour cells with intense lymphoplasmacytic infiltrate. Unusual morphological findings, including eosinophils focally aggregated in one tumour admixed with multinucleated histiocytes in small clusters, fibrinoid deposits in the walls of ectatic blood vessel with occasional perivascular cuffs of lymphocytes, hyalinized fibrosis, and epithelioid granuloma, were identified. The tumour cells were immunoreactive for CD21, CD23, CD35, smooth muscle actin, and Epstein-Barr virus (EBV)-encoded latent membrane protein 1 (7/10, 70%). EBV-encoded small RNA was positive in all cases by in situ hybridization. The recurrence rate was 10% with a median follow-up of 19 months. CONCLUSIONS Inflammatory pseudotumour-like FDC tumour should be differentiated from inflammatory myofibroblastic tumour, Hodgkin lymphoma, interdigitating dendritic cell sarcoma, and gastrointestinal stromal tumour.
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Affiliation(s)
- Yanyang Chen
- Department of Pathology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Huijuan Shi
- Department of Pathology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hui Li
- Department of Pathology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Tiantian Zhen
- Department of Pathology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Anjia Han
- Department of Pathology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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