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Mishra PP, Madan K, Biswas S, Kini Rao AC. Fibroblastic reticular cell tumor of eyelid: Rare case report and review of literature. INDIAN J PATHOL MICR 2024; 67:166-168. [PMID: 38358212 DOI: 10.4103/ijpm.ijpm_908_21] [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: 02/16/2024] Open
Abstract
Fibroblastic reticular cell tumours (FRCT) originate from the fibroblastic reticular cells (FBRC) which are histiocytic cells, belonging to the dendritic cell family. These tumours are extremely rare, with only a few cases reported in literature. Histomorphologically, they resemble follicular dendritic cell sarcoma (FDCS); however, they differ immunophenotypically. Extranodal presentations are rare. We report a case of malignant FBRC tumour of the left eyelid, in a 23-year-old woman, who had presented with a recurrent swelling over left lower eyelid. Microscopy revealed an ill circumbscribed tumour composed of oval to spindle cells in storiform pattern, sprinkled with lymphocytes. Immunohistochemistry was performed and diagnosis of FRCT was offered. To the best of our knowledge, this is the first report of malignant FBRC tumour arising in the eyelid region. Here we present this extremely rare case with review of the available literature.
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Affiliation(s)
- Pragnya P Mishra
- Department of Oncopathology, Yenepoya Medical College, Mangalore, Karnataka, India
| | - K Madan
- Department of Oncopathology, Yenepoya Medical College, Mangalore, Karnataka, India
| | - Siddhartha Biswas
- Department of Oncopathology, Yenepoya Medical College, Mangalore, Karnataka, India
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Mainardi F, Lombardi M, Covello R, Saponaro A, Costarelli L, Giordano M, Monardo F. An unusual case of extra-nodal interdigitating dendritic cell neoplasm: sarcoma or not? Acta Chir Belg 2023; 123:687-690. [PMID: 35833666 DOI: 10.1080/00015458.2022.2102358] [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] [Received: 12/23/2021] [Accepted: 07/09/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Interdigitating dendritic cell sarcoma (IDCS) represents an extremely rare neoplasm frequently originating from T-cell- associated dendritic antigen-presenting cells normally populating the paracortex of lymph nodes. Diagnosis is challenging due to the rarity of this neoplasm and the overlapping features with the other primary and metastatic spindle cell neoplasm, even more, when localized in an extra-nodal site. PATIENTS AND METHODS Herein we report a case of 48 Years old woman with a six-month history of centimetric, quiet painful mass of the philtrum without other significant comorbidity. RESULTS Histological report showed a proliferation of quiet bland spindle to plump cell, scattered multinucleated giant cell in a subtle background of lymphocytes. IHC study displays only positivity for S-100 and fine, granular scattered cytoplasmatic stain for CD68; all dendritic IHC markers were negative. Morphological and immunohistochemical analyses were consistent with extra-nodal Interdigitating Dendritic Cell Neoplasm. CONCLUSION Interdigitating Dendritic Cell Sarcoma is a rare and challenging entity with a variable prognosis. We present a case of extra-nodal IDCS whit low worrisome histological features, emphasizing the need for further efforts to better definitely this rare neoplasm ad its potential for malignancy.
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Affiliation(s)
- Federico Mainardi
- Pathology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | | | - Renato Covello
- Department of Pathology, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Angelo Saponaro
- Surgical Department, Army hospital of Rome "Celio", Roma, Italy
| | | | - Marco Giordano
- Department of Pathology, San Giovanni Addolorata Hospital, Rome, Italy
| | - Francesca Monardo
- Department of Pathology, San Giovanni Addolorata Hospital, Rome, Italy
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3
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Dainese E, Cimetti L, Pozzi B, Milani M, Russo G, Castelnuovo S, Viganò CV, Cerati M, Uccella S, Vanzati A. Primary cutaneous interdigitating dendritic cell sarcoma (IDCS): Report of a new case and literature review. Pathol Res Pract 2023; 247:154559. [PMID: 37210770 DOI: 10.1016/j.prp.2023.154559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/18/2023] [Indexed: 05/23/2023]
Abstract
Interdigitating dendritic cell sarcoma is a very rare entity in the spectrum of histiocytic and dendritic cell neoplasms that mostly occurs in lymph nodes, generally presenting as solitary lymphadenopathy, but may affect every organ. Among extra nodal sites, cutaneous interdigitating dendritic cell sarcoma is exceedingly rare; to date, only 9 cases have been described in English literature. The mean age at diagnosis was 60 years, with a male-female ratio of 1,5 to 1; clinically, two different modalities of skin presentation have been reported: solitary, represented by a single red-brownish nodular lesion, or diffuse, characterized by multiple nodular lesions in one or more body districts. The extreme rarity of this sarcoma and its morphological similarity to other poorly differentiated tumors may lead to a delay in diagnosis; in particular, cutaneous localization may be difficult to differentiate from follicular dendritic cell sarcoma, Langerhans cell sarcoma, poorly differentiated squamous cell carcinoma and more generally sarcomatoid carcinoma, atypical fibroxanthoma, malignant melanoma and several sarcomas. Immunohistochemistry plays an important role in identifying this rare entity and formulating a correct histological diagnosis, fundamental requirement for choosing the best therapeutic approach. We report herein a further case of an 81-year-old Caucasian woman who presented to the Dermatology Department to remove an asymptomatic skin papule in the left temporal region, clinically diagnosed as dermatofibroma. The overall pathological and immunohistochemical features supported the diagnosis of a malignant dendritic cell tumor, consistent of interdigitating dendritic cell sarcoma.
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Affiliation(s)
- E Dainese
- Surgical Pathology Division, Department of Oncology, ASST Lecco, A. Manzoni Hospital, Lecco, Italy.
| | - L Cimetti
- Surgical Pathology Division, Department of Oncology, ASST Lecco, A. Manzoni Hospital, Lecco, Italy
| | - B Pozzi
- Surgical Pathology Division, Department of Oncology, ASST Lecco, A. Manzoni Hospital, Lecco, Italy
| | - M Milani
- Surgical Pathology Division, Department of Oncology, ASST Lecco, A. Manzoni Hospital, Lecco, Italy
| | - G Russo
- Dermatology Division, Department of Medicine, ASST Lecco, A. Manzoni Hospital, Lecco, Italy
| | - S Castelnuovo
- Department of Radiology, ASST-Lecco, A. Manzoni Hospital, Lecco, Italy
| | - C V Viganò
- Department of Oncology, ASST-Lecco, A. Manzoni Hospital, Lecco, Italy
| | - M Cerati
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, ASST Sette Laghi, Varese, Italy
| | - S Uccella
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - A Vanzati
- Surgical Pathology Division, Department of Oncology, ASST Lecco, A. Manzoni Hospital, Lecco, Italy
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4
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Sakurai M, Yamamoto Y, Tamaru M, Shimoda H, Sakai Y, Morimoto M. Disseminated histiocytic sarcoma in a squirrel monkey (Saimiri sciureus). J Med Primatol 2023; 52:121-124. [PMID: 36286409 DOI: 10.1111/jmp.12625] [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: 04/07/2022] [Revised: 09/25/2022] [Accepted: 10/03/2022] [Indexed: 11/29/2022]
Abstract
A 14-years-old squirrel monkey was euthanized due to weakness. Histopathological examination revealed multifocal growth of oval cells with severe atypia in the liver, spleen, and bone marrow. The neoplastic cells were positive for histiocytic markers (Iba1, HLA-DR, CD204). This is the fourth case of histiocytic sarcoma in non-human primates.
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Affiliation(s)
- Masashi Sakurai
- Department of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yoshida, Yamaguchi, Japan
| | - Yukihiro Yamamoto
- Department of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yoshida, Yamaguchi, Japan
| | | | - Hiroshi Shimoda
- Department of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yoshida, Yamaguchi, Japan
| | - Yusuke Sakai
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masahiro Morimoto
- Department of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yoshida, Yamaguchi, Japan
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5
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Jenei A, Bedics G, Erdélyi DJ, Müller J, Györke T, Bödör C, Szepesi Á. Potential role of MAP2K1 mutation in the trans-differentiation of interdigitating dendritic cell sarcoma: Case report and literature review. Front Pediatr 2022; 10:959307. [PMID: 36186629 PMCID: PMC9523154 DOI: 10.3389/fped.2022.959307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
A 5-year-old male child was diagnosed with interdigitating dendritic cell sarcoma (IDCS) during his maintenance therapy for B-cell precursor acute lymphoblastic leukemia (B-ALL). Multiplex lymph node involvements of the neck were found by positron emission tomography CT (PET-CT). Treatments, including surgical and chemotherapy, resulted in complete remission. Four years later, systemic bone infiltration was discovered. Surgical resection of the IV rib and intensive chemotherapy led to a complete morphological remission, and allogeneic bone marrow transplantation was performed. Comprehensive genomic profiling of the formalin fixed the tumor tissue, and the cryopreserved leukemic cells revealed several common alterations and divergent clonal evolution with a novel MAP2K1 mutation of the IDCS, which is responsible for the trans-differentiation of the common lymphoid-committed tumor progenitor.
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Affiliation(s)
- Alex Jenei
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Gábor Bedics
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary.,Hungarian Centre of Excellence for Molecular Medicine - Semmelweis University (HCEMM-SE) Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Dániel J Erdélyi
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Judit Müller
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Tamás Györke
- Department of Nuclear Medicine Semmelweis University, Budapest, Hungary
| | - Csaba Bödör
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary.,Hungarian Centre of Excellence for Molecular Medicine - Semmelweis University (HCEMM-SE) Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Ágota Szepesi
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
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Cassidy DP, Rosenberg AE, Poveda J, Velez-Torres J, Chapman J. Nonlymphoid Hematopoietic Diseases Presenting in Bone, Soft Tissue, and Other Extranodal Sites. Arch Pathol Lab Med 2021; 146:1144-1159. [DOI: 10.5858/arpa.2021-0229-ra] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 11/06/2022]
Abstract
Context.—
Although rare in everyday practice, the initial presentation of hematopoietic neoplasms other than lymphoma in the musculoskeletal system and other extranodal sites can generate challenging diagnostic problems for surgical pathologists.
Objective.—
To review the morphologic and immunophenotypic features of various nonlymphoid hematopoietic diseases presenting at extranodal sites, with emphasis on the inherent diagnostic pitfalls and differential diagnoses of these entities to aid surgical pathologists in their accurate recognition.
Data Sources.—
Cases reviewed herein represent both in-house and consult cases seen at our institution between 2010 and 2021.
Conclusions.—
Entities that present in this way include myeloid neoplasms and histiocytic/dendritic cell neoplasms. These tumors commonly cause nonspecific symptoms, and their histologic appearance can overlap with a variety of benign neoplasms and reactive processes. This can lead to delay in diagnosis and intervention with potentially lifesaving therapy; thus, accurate and expedient recognition is of paramount importance.
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Affiliation(s)
- Daniel P. Cassidy
- From the Division of Hematopathology (Cassidy, Poveda, Chapman), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Division of Bone and Soft Tissue Pathology (Cassidy, Rosenberg, Velez-Torres), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Andrew E. Rosenberg
- Division of Bone and Soft Tissue Pathology (Cassidy, Rosenberg, Velez-Torres), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Julio Poveda
- From the Division of Hematopathology (Cassidy, Poveda, Chapman), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Jaylou Velez-Torres
- Division of Bone and Soft Tissue Pathology (Cassidy, Rosenberg, Velez-Torres), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Jennifer Chapman
- From the Division of Hematopathology (Cassidy, Poveda, Chapman), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
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Hao P, Cao L, Li Y, Lin D, Hu T, Wu T. Interdigitating dendritic cell sarcoma located in the adrenal gland: a case report and literature review. J Int Med Res 2021; 49:3000605211055410. [PMID: 34772309 PMCID: PMC8593323 DOI: 10.1177/03000605211055410] [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] [Indexed: 11/19/2022] Open
Abstract
We report a case of interdigitating dendritic cell sarcoma (IDCS) originating from the adrenal gland. A 57-year-old middle-aged woman with no previous history of malignancy came to our hospital after color Doppler ultrasound revealed a right adrenal mass. An abdominal computed tomography scan also showed an adrenal mass. Postoperative pathology confirmed the diagnosis of IDCS. After complete surgical removal of the adrenal tumor, the patient has been disease-free for 1 year. IDCS may have a good prognosis after surgical resection. To our knowledge, this is only the second reported case of IDCS in the adrenal region.
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Affiliation(s)
- Peng Hao
- Department of Urology, 117913Affiliated Hospital of North Sichuan Medical College, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Liang Cao
- Department of Urology, 117913Affiliated Hospital of North Sichuan Medical College, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Yangming Li
- Department of Urology, 117913Affiliated Hospital of North Sichuan Medical College, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Dong Lin
- Department of Urology, Pengzhou People's Hospital, Pengzhou, Sichuan, China
| | - Tinghui Hu
- Department of Urology, Emei City People's Hospital, Emeishan, Sichuan, China
| | - Tao Wu
- Department of Urology, 117913Affiliated Hospital of North Sichuan Medical College, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
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Lakshmanan A, Kurian A, Annapurneswari S. Interdigitating dendritic cell sarcoma involving head and neck region- a report of four cases with review of literature. HUMAN PATHOLOGY: CASE REPORTS 2021. [DOI: 10.1016/j.ehpc.2021.200514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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9
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Mellert K, Benckendorff J, Leithäuser F, Zimmermann K, Wiegand P, Frascaroli G, Buck M, Malaise M, Hartmann G, Barchet W, Fürst D, Mytilineos J, Mayer-Steinacker R, Viardot A, Möller P. U-DCS: characterization of the first permanent human dendritic sarcoma cell line. Sci Rep 2020; 10:21221. [PMID: 33277516 PMCID: PMC7718904 DOI: 10.1038/s41598-020-77471-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 10/21/2020] [Indexed: 11/09/2022] Open
Abstract
A dendritic cell sarcoma cell line, U-DCS, was established from a dendritic cell sarcoma in a 53-year-old Caucasian male patient. Since its establishment, U-DCS has maintained stable phenotypic characteristics in vitro and has a doubling time of approximately 2 days under standard culture conditions. U-DCS is growing with typical dendritic cell morphology in tissue and expresses the dendritic cell sarcoma immunophenotypic markers S100 protein, MHCI, MHCII, and vimentin. Expression analysis revealed transcripts for the toll-like receptors TLR3, -4, -9 and DDX58 (RIG-I), but not for TLR2. U-DCS shows functional features of dendritic cells with the ability of phagocytosis and antigen-specific T cell stimulation. Karyotype-, CGH-, and mFISH analysis point to a chromosomal instability and a hypotetraploid karyotype with approximately 130 chromosomes. U-DCS is the first immortalized human dendritic cell sarcoma cell line and has some morphological and functional features of dendritic cells without dependency on growth factors.
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Affiliation(s)
- Kevin Mellert
- Institute of Pathology, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Julian Benckendorff
- Institute of Pathology, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Frank Leithäuser
- Institute of Pathology, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Katarzyna Zimmermann
- Institute of Pathology, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Peter Wiegand
- Institute for Forensic Medicine, University Hospital Ulm, Ulm, Germany
| | | | - Michaela Buck
- Institute of Pathology, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Muriel Malaise
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Regensburg, Regensburg, Germany
| | - Gunther Hartmann
- Institute for Clinical Chemistry and Pharmacology, University of Bonn, Bonn, Germany
| | - Winfried Barchet
- Institute for Clinical Chemistry and Pharmacology, University of Bonn, Bonn, Germany
| | - Daniel Fürst
- Institute of Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service, Baden Württemberg-Hessen, Ulm, Germany
| | - Joannis Mytilineos
- Institute of Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service, Baden Württemberg-Hessen, Ulm, Germany
| | | | - Andreas Viardot
- Department of Internal Medicine 3, University Hospital Ulm, Ulm, Germany
| | - Peter Möller
- Institute of Pathology, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
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Kaji S, Hiruta N, Sasai D, Nagashima M, Ohe R, Yamakawa M. Cytokeratin-positive interstitial reticulum cell (CIRC) tumor in the lymph node: a case report of the transformation from the epithelioid cell type to the spindle cell type. Diagn Pathol 2020; 15:121. [PMID: 32979929 PMCID: PMC7519525 DOI: 10.1186/s13000-020-01032-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 09/09/2020] [Indexed: 12/03/2022] Open
Abstract
Background Cytokeratin-positive interstitial reticulum cells (CIRCs), which are a subgroup of fibroblastic reticular cells (FRCs), are known to be present in the lymph nodes. There have been only a few cases of tumors derived from CIRCs. Case presentation We have reported a new case involving a CIRC tumor in a 75-year-old man and reviewed the literature. The resected mediastinal lymph nodes showed epithelial-like proliferation of large atypical round and polygonal epithelioid cells. The tumor cells expressed CK8, CK18, CAM5.2, AE1/AE3, epithelial membrane antigen, vimentin, fascin, and some FRC markers, which is consistent with the diagnosis of a CIRC tumor. Following chemotherapy, the CIRC tumor was observed to have responded very well and became difficult to confirm on imaging, but a small cell lung carcinoma developed 12 months later. Chemoradiotherapy was performed, but the patient passed away 29 months after the initial diagnosis. The autopsy revealed the recurrence of the CIRC tumor, residual small cell lung carcinoma, and a very small latent carcinoma of the prostate. The relapsed CIRC tumor cells had a spindle shape; they were highly pleomorphic and had invaded the superior vena cava. Conclusion We first reported autopsy findings of CIRC tumors and demonstrated the transformation of the tumor from the epithelioid cell type to the spindle cell type.
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Affiliation(s)
- Sachiko Kaji
- Department of Diagnostic Pathology, Chiba Kaihin Municipal Hospital, 3-31-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan.
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Daisuke Sasai
- Department of Pathology, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Makoto Nagashima
- Department of Surgery, Toho University Sakura Medical Center, Sakura, Japan
| | - Rintaro Ohe
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Mitsunori Yamakawa
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata, Japan
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Muhammed A, Ahmed ARH, Maysa H, Mohamed AES, Abd-ElLateef AAE, Elnakib E. New insights inside the interdigitating dendritic cell sarcoma—pooled analysis and review of literature. Ann Hematol 2019; 98:2641-2651. [DOI: https:/doi.org/10.1007/s00277-019-03824-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 10/11/2019] [Indexed: 08/30/2023]
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12
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Muhammed A, Ahmed ARH, Maysa H, Mohamed AES, Abd-ElLateef AAE, Elnakib E. New insights inside the interdigitating dendritic cell sarcoma—pooled analysis and review of literature. Ann Hematol 2019; 98:2641-2651. [DOI: 10.1007/s00277-019-03824-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 10/11/2019] [Indexed: 12/24/2022]
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13
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Kajimoto Y, Otsuki N, Teshima M, Morinaga Y, Itoh T, Nibu KI. Successful Treatment of Interdigitating Dendritic Cell Sarcoma Presenting as Multiple Parotid Tumors. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2019. [DOI: 10.1080/23772484.2019.1635887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Yasuyuki Kajimoto
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naoki Otsuki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Teshima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yukiko Morinaga
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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14
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Zhao C, Xie X, Gai DZ, Wu D, Xin H, Yang T. Interdigitating dendritic cell sarcoma of the spleen with hepatic failure after chemotherapy: A case report. Medicine (Baltimore) 2019; 98:e15535. [PMID: 31083204 PMCID: PMC6531197 DOI: 10.1097/md.0000000000015535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
RATIONALE Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare disease originating from dendritic cells (DCs). There are few cases report interdigitating dendritic cell sarcoma of spleen along with their pathological characteristics and treatment. PATIENT CONCERNS Here we report a case of IDCS in 53-year-old female who presented spleen enlargement and thrombocytopenia. DIAGNOSES The patient underwent surgical resection of spleen, and the pathology confirmed IDCS. INTERVENTIONS She received surgical resection of spleen and one cycle of chemotherapy (ABVD with ifosfamide and oxaliplatin) after surgery. OUTCOMES She died of severe hepatic failure caused by chemotherapy. DISCUSSION IDCS is a rare disease with insufficient treatment guidelines. We adopted chemotherapy of ABVD with ifosfamide and oxaliplatin which showed no improvement but led to life-threatening liver damage.
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Affiliation(s)
| | - Xiaohui Xie
- Nephrology Division, Xiangya Hospital, Central South University, Changsha, People's Republic of China
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15
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Histiocytic Sarcoma Associated With Follicular Lymphoma: Evidence for Dramatic Response With Rituximab and Bendamustine Alone and a Review of the Literature. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2019; 19:e1-e8. [DOI: 10.1016/j.clml.2018.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 10/06/2018] [Indexed: 11/22/2022]
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16
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Wang HT, Xu HY, Zhang R, Liu ZG, Zhang GJ. Interdigitating dendritic cell sarcoma located in the groin: a case report and literature review. J Int Med Res 2018; 46:4791-4799. [PMID: 30222020 PMCID: PMC6259359 DOI: 10.1177/0300060518792444] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare subtype of dendritic cell neoplasms, and current knowledge on this tumor is limited. We herein report a case of an IDCS in a 64-year-old man who presented with a right inguinal mass combined with extensive retroperitoneal, pulmonary, hepatic, renal, and bone marrow infiltration. Because of the advanced stage of the disease, we performed five cycles of chemotherapy, including cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP); doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD); and ABVD combined with cisplatin, and one cycle of radiotherapy. The patient’s inguinal mass became smaller during the treatment, but there was no change in the extent of infiltration at the other sites. The patient died 8 months after the initial diagnosis. We also herein review the etiology, diagnosis, differential diagnosis, treatment, and prognosis of IDCS, and analyze the characteristics of IDCS in Chinese patients.
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Affiliation(s)
- Hong-Tao Wang
- 1 First Department of Hematology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, P.R. China
| | - Hong-Yang Xu
- 1 First Department of Hematology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, P.R. China.,2 Intensive Care Unit, Taizhou Central Hospital, Taizhou, Zhejiang, P.R. China
| | - Rong Zhang
- 1 First Department of Hematology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, P.R. China
| | - Zhuo-Gang Liu
- 1 First Department of Hematology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, P.R. China
| | - Guo-Jun Zhang
- 1 First Department of Hematology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, P.R. China
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Spindle Cell Melanoma and Interdigitating Dendritic Cell Sarcoma: Do They Represent the Same Process? Am J Surg Pathol 2017; 40:1270-9. [PMID: 27299798 DOI: 10.1097/pas.0000000000000678] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Intranodal spindle cell lesions on biopsy are problematic for a surgical pathologist, often requiring an extensive immunohistochemical evaluation with variable and frequently unsatisfactory results. In the absence of a history of malignancy, the differential diagnosis of a spindle cell tumor must include both a primary nodal proliferation and a metastatic process. Particularly challenging are those lesions that share morphologic and immunohistochemical features; spindle cell melanomas (SCM) and interdigitating dendritic cell sarcomas (IDCS) belong to this category. At present, electron microscopy is the only method proposed to distinguish between the 2 entities; however, this method is often unavailable and impractical. In this study, we assessed the comparative immunophenotypes of 18 cases of SCM and 8 cases of IDCS, with particular emphasis on the expression of MUM-1, β-catenin, SOX-10, MiTF, and p75. Our results showed nearly equivalent staining patterns and profiles; 12% and 17% of IDCS and SCM were labeled for MUM-1, 75% and 83% stained for β-catenin, 0% and 24% expressed MiTF, and 100% and 94% labeled for p75, respectively. All cases of IDCS and SCM displayed strong nuclear reactivity for SOX-10. On the basis of our study and pertinent literature, the morphologic and immmunophenotypic features of SCM and IDCS appear to be virtually indistinguishable from one another, raising the question as to whether these 2 entities represent a pathobiologically similar or even identical process.
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18
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Diffuse lesion and necrosis tied to poorer prognosis of interdigitating dendritic cell sarcoma: cases report and a pooled analysis. Sci Rep 2017; 7:667. [PMID: 28386111 PMCID: PMC5429666 DOI: 10.1038/s41598-017-00719-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 03/09/2017] [Indexed: 11/08/2022] Open
Abstract
Interdigitating dendritic cell sarcoma is a neoplastic proliferation of interdigitating dendritic cells and no therapeutic consensus exists. This study aimed to investigate the prognostic impacts of tumor lesion, cellular atypia, mitosis and necrosis on the interdigitating dendritic cell sarcoma. Case reports and pooled analyses were designed to explore the relationships. One case was a 40-years old man with localized lesion, moderate to notable cellular atypia, 30 mitoses per 10 high-power fields and no necrosis and the progression-free survival was longer than 20 months. The other case was a 62-years old woman with diffuse lesion, notable cellular atypia, less than one mitosis per 10 high-power fields and diffuse necrosis and the progression-free survival was shorter than 1 month. Cellular atypia and mitosis had not any relationship with survival. Compared with localized lesion, diffuse lesion presented a 2.92-fold risk of progression (HR = 2.92, 95% CI 1.01, 8.51) and an 8.79-fold risk of death (HR = 8.79, 95% CI 1.86, 41.64). Diffuse necrosis presented a 4.39-fold higher progression risk (HR = 5.39, 95% CI 1.78, 16.29) and a 5.37-fold higher death risk (HR = 6.37, 95% CI 1.46, 27.86) than focal or no necrosis. Diffuse lesion and diffuse necrosis were indicators of poorer prognosis and the clinical application should be warranted in further studies.
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19
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Primary cutaneous interdigitating dendritic cell sarcoma is a morphologic and phenotypic simulator of poorly differentiated metastatic melanoma: A report of 2 cases and review of the literature. Ann Diagn Pathol 2017; 30:59-65. [PMID: 28302385 DOI: 10.1016/j.anndiagpath.2017.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 02/17/2017] [Indexed: 01/08/2023]
Abstract
Interdigitating dendritic cell sarcoma (IDS) is a rare form of hematologic malignancy associated with an aggressive clinical course. Only 4 prior cases have been described as originating in the skin. We encountered two male patients ages 47 and 61years of age who presented with solitary cutaneous neoplasms diagnosed as IDS. Histologic exam showed a coalescing nested and multinodular proliferation of large pleomorphic epithelioid cells. In one case an initial diagnosis of melanoma was rendered. A recurrence 8months later was then interpreted as a primary cutaneous IDS. This patient died of widespread metastatic disease within 2years from his initial surgery. The other patient has recently undergone wide excision and radiation without any recurrence or metastatic disease during this short follow up time period. Both patients had a tumor exhibiting the same phenotypic profile comprising leukocyte common antigen, SOX10, S100, CD68, and CD163 positivity. In reviewing the 4 other reported cases, there is a similar older male predominance (mean age of 58years) although women affected were significantly younger (mean age of 28years); there was a predilection for the proximal extremities and the face. Patients treated with excision only developed recurrent disease with one patient subsequently dying of metastatic disease. Primary cutaneous IDS is a highly aggressive hematologic malignancy that has many overlapping features with poorly differentiated epithelioid and spindle cell melanoma including SOX10 staining. An aggressive treatment protocol at the beginning could optimize patient survival.
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20
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Di Liso E, Pennelli N, Lodovichetti G, Ghiotto C, Dei Tos AP, Conte P, Bonanno L. Braf mutation in interdigitating dendritic cell sarcoma: a case report and review of the literature. Cancer Biol Ther 2016; 16:1128-35. [PMID: 26047060 DOI: 10.1080/15384047.2015.1057359] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Interdigitating dendritic cell sarcoma is an extremely rare tumor. The diagnosis is difficult and is based on clinical, pathological and immunohistochemical evaluation. Differential diagnosis includes melanoma, mesenchymal and hematological malignancies. The mainstay of treatment is surgery for limited disease and different chemotherapy combinations have been tested for advanced disease. No evidence from prospective trials is currently available. We report the case of a 59 year-old male patient who experienced axillary lymphadenopathy with initial diagnosis of large-cell lung cancer on tumor biopsy. He underwent surgical resection with radical intent. Pathological diagnosis of interdigitating dendritic cell sarcoma was obtained on surgical samples. Nine months after radical surgery, he experienced systemic recurrence of disease and underwent chemotherapy with epirubicin and ifosfamide for 4 courses. During chemotherapy, he developed brain disease progression and underwent whole-brain radiotherapy. Systemic progression was then observed and molecular characterization was performed. B-RAF evaluation resulted positive for V600E mutation and the patient was treated with Vemurafenib according to molecular findings. He thus obtained initial clinical benefit but eventually died of brain hemorrhage. In conclusion, we report a case of B-RAF mutation detected in an interdigitating dendritic cell sarcoma patient treated with targeted therapy. B-RAF pathway could have a role in pathogenesis and evolution of this rare disease and could open new perspectives of treatment.
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Key Words
- 18FDG- PET-CT, 18fluorodeoxyglucose-positron emission tomography-computed tomography
- ALK, anaplastic lymphoma kinase
- ATP, adenosine triphosphate
- B-RAF
- BCL2, B-cell lymphoma 2
- CD, cluster of differentiation
- CT, computed tomography
- CTCAE, common terminology criteria for adverse events
- ECG, electrocardiogram
- ECOG, eastern cooperative oncology group
- EMA, ephitelial membrane antigen
- H3Ac, acetylated histone H3
- HLA, human leukocyte antigen
- Ig, immunoglobulin
- IgH, heavy immunoglobulin
- MHC, Major Histocompatibility Complex
- MRI, magnetic resonance imaging
- NSE, neuron specific enolase
- PS, performance status
- QTc, corrected QT interval
- SUV, standardized uptake value
- TCR, t cell receptor
- TIM, T cell immunoglobulin mucin
- Vemurafenib
- WHO, world health organization
- differential diagnosis
- interdigitating dendritic cell sarcoma
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Affiliation(s)
- Elisabetta Di Liso
- a Medical Oncology 2 ; Istituto Oncologico Veneto IRCCS ; Padova , Italy
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21
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Kyogoku C, Seki M, Ogawa S, Miyamoto K, Ito Y, Kurita N, Yokoyama Y, Sakata-Yanagimoto M, Obara N, Hasegawa Y, Fujishima F, Ichinohasama R, Nakamura S, Chiba S. Complete Remission in Systemic Skin Interdigitating Dendritic Cell Sarcoma after ABVD Chemotherapy. J Clin Exp Hematop 2016; 55:33-7. [PMID: 26106005 DOI: 10.3960/jslrt.55.33] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Interdigitating dendritic cell sarcoma (IDCS) is a rare and aggressive neoplasm that is thought to arise from dendritic cells. This disease usually involves the lymph nodes and, rarely, extra-nodal sites. We report a 62-year-old man presenting skin nodules in the head, body, and extremities, as well as bone marrow involvement. Morphologic analysis of a biopsied specimen from the skin lesion was consistent with IDCS. Immunohistochemical staining demonstrated that the tumor cells were positive for IDCS-associated antigens such as CD4, CD45, CD68 (KP-1), and S-100 protein. Complete remission was achieved by treatment with 6 cycles of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine) chemotherapy. Although the optimal treatment of IDSC remains unknown, the experience in the current case supports the notion that ABVD chemotherapy may be effective for IDCS, and further extends this idea to rare patients presenting multiple skin lesions.
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Affiliation(s)
- Chieko Kyogoku
- Department of Hematology, Faculty of Medicine, University of Tsukuba
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22
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Li H, Shen P, Liang Y, Zhang F. Fibroblastic reticular cell tumor of the breast: A case report and review of the literature. Exp Ther Med 2015; 11:561-564. [PMID: 26893647 DOI: 10.3892/etm.2015.2922] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 11/18/2015] [Indexed: 01/16/2023] Open
Abstract
Fibroblastic reticular cells (FBRCs) are basic mesenchymal cells that belong to the dendritic cell family. Primary extranodal FBRC tumor (FRCT) cases are rare, with only 19 cases reported in the literature thus far. However, none of these cases originated in the breast tissue. To the best of our knowledge, the present study reported the first FRCT case of the breast in a 57-year-old woman. The patient complained of a painless mass that was located in the right breast and was ~3.5×2.5 cm in size. The patient underwent modified radical mastectomy subsequent to the diagnosis of FRCT after analysis of the lumpectomy specimen. Pathological examination revealed that the tumor was mainly composed of oval and spindle cells, and was infiltrated with lymphocytes and plasma cells. The tumor cells were immunoreactive for vimentin and negative for CD21, CD35 and S-100 protein. Six axillary lymph nodes were found to have been involved. Following surgery, the patient received four cycles of mesna, doxorubicin, ifosfamide and dacarbazine regimen chemotherapy (70 mg adriamycin day 1; 2.0 g ifosfamided days 1-3; 0.4 g dacarbazine day 1-3), which cycled every 21 days. The patient was uneventfully followed-up for 20 months following chemotherapy. In conclusion, the present study reported what appeared to be the first case of primary breast FRCT. The diagnosis, treatment and prognosis details presented in this study will help improve the diagnosis of the disease.
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Affiliation(s)
- Hongmei Li
- Department of Pathology, Ninghai Maternity and Child Care Hospital, Ninghai, Zhejiang 315600, P.R. China
| | - Pingrong Shen
- Department of Gynaecology and Obstetrics, Ninghai Maternity and Child Care Hospital, Ninghai, Zhejiang 315600, P.R. China
| | - Yun Liang
- Department of Pathology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, P.R. China
| | - Feng Zhang
- Department of Surgery, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, P.R. China
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23
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Tumoren dendritischer und anderer akzessorischer Zellen der Lymphknoten. DER PATHOLOGE 2015; 36:467-76. [DOI: 10.1007/s00292-015-0042-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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24
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Hutter G, Hofer S, Tzankov A, Kothbauer KF. Intracranial Interdigitating Dendritic Cell Sarcoma. Neurosurgery 2015; 77:E979-83. [DOI: 10.1227/neu.0000000000000925] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND IMPORTANCE:
This is the first report of a primarily intracranial interdigitating dendritic cell sarcoma (IDCS).
CLINICAL PRESENTATION:
A 39-year-old patient with right hemiparesis underwent complete resection of a large parafalcine tumor with subsequent complete recovery of neurological symptoms. Histologically, the tumor was diagnosed as IDCS. Extensive staging did not reveal any extracranial manifestation of this disease. After 1.5 years, the patient remains recurrence free and is being observed closely.
CONCLUSION:
IDCS are exceedingly rare tumors and so far have not been found intracranially. On the basis of the limited experience with extracranial occurrence, this tumor is best managed by complete resection and careful oncological observation.
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Affiliation(s)
- Gregor Hutter
- Division of Neurosurgery, Luzerner Kantonsspital, Luzern, Switzerland
| | - Silvia Hofer
- Division of Oncology, Luzerner Kantonsspital, Luzern, Switzerland
| | | | - Karl F. Kothbauer
- Division of Neurosurgery, Luzerner Kantonsspital, Luzern, Switzerland
- Division of Neurosurgery, University of Basel, Basel, Switzerland
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25
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Khashab T, Sehgal L, Medeiros LJ, Samaniego F. Spontaneous regression of interdigitating dendritic sarcoma in a patient with concurrent small lymphocytic lymphoma. BMJ Case Rep 2015; 2015:bcr-2014-209014. [PMID: 26071439 DOI: 10.1136/bcr-2014-209014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Interdigitating dendritic cell sarcoma (IDCS) is a rare tumour; only seven cases of IDCS associated with chronic lymphocytic leucaemia/small lymphocytic lymphoma (CLL/SLL) have been reported. We present the case of a 60-year-old man who presented with fevers, night sweats and significant unintentional weight loss. Investigations led to a diagnosis of synchronous SLL and IDCS. Subsequent fluorodeoxyglucose (FDG) positron emission tomography CT (PET-CT) imaging revealed an unusual clinical course with spontaneously resolving highly metabolic lesions. After 42 months of follow-up, the patient remains free of clinical symptoms and evidence of IDCS.
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Affiliation(s)
- Tamer Khashab
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lalit Sehgal
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Felipe Samaniego
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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26
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Dalia S, Shao H, Sagatys E, Cualing H, Sokol L. Dendritic cell and histiocytic neoplasms: biology, diagnosis, and treatment. Cancer Control 2015; 21:290-300. [PMID: 25310210 DOI: 10.1177/107327481402100405] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Dendritic and histiocytic cell neoplasms are rare malignancies that make up less than 1% of all neoplasms arising in lymph nodes or soft tissues. These disorders have distinctive disease biology, clinical presentations, pathology, and unique treatment options. Morphology and immunohistochemistry evaluation by a hematopathologist remains key for differentiating between these neoplasms. In this review, we describe tumor biology, clinical features, pathology, and treatment of follicular dendritic cell sarcoma, interdigitating dendritic cell sarcoma, indeterminate dendritic cell sarcoma, histiocytic sarcoma, fibroblastic reticular cell tumors, and disseminated juvenile xanthogranuloma. METHODS A literature search for articles published between 1990 and 2013 was undertaken. Articles are reviewed and salient findings are systematically described. RESULTS Patients with dendritic cell and histiocytic neoplasms have distinct but variable clinical presentations; however, because many tumors have recently been recognized, their true incidence is uncertain. Although the clinical features can present in many organs, most occur in the lymph nodes or skin. Most cases are unifocal and solitary presentations have good prognoses with surgical resection. The role of adjuvant therapy in these disorders remains unclear. In cases with disseminated disease, prognosis is poor and data on treatment options are limited, although chemotherapy and referral to a tertiary care center should be considered. Excisional biopsy is the preferred method of specimen collection for tissue diagnosis, and immunohistochemistry is the most important diagnostic method for differentiating these disorders from other entities. CONCLUSIONS Dendritic cell and histiocytic cell neoplasms are rare hematological disorders with variable clinical presentations and prognoses. Immunohistochemistry remains important for diagnosis. Larger pooled analyses or clinical trials are needed to better understand optimal treatment options in these rare disorders. Whenever possible, patients should be referred to a tertiary care center for disease management.
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Affiliation(s)
- Samir Dalia
- Mercy Clinic Oncology-Hematology, Joplin, MO 64804, USA.
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27
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Lupato V, Romeo S, Franchi A, Mantovani M, Dei Tos AP, Tirelli G, Da Mosto MC, Boscolo-Rizzo P. Head and Neck Extranodal Interdigitating Dendritic Cell Sarcoma: Case Report and Review of the Literature. Head Neck Pathol 2015; 10:145-51. [PMID: 25893828 PMCID: PMC4838954 DOI: 10.1007/s12105-015-0627-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 04/10/2015] [Indexed: 11/29/2022]
Abstract
Interdigitating dendritic cell sarcoma (IDCS) is an exceedingly rare neoplasm originating from professional antigen presenting cells normally located in the T zone of the lymph node. The purpose of this report was to describe the first case of the IDCS of the submandibular gland and perform a review of the literature of head and neck IDCS. We present a case of an 81-year-old man with a 5 months history of slowly enlarging painless mass in right submandibular region. Fine needle aspiration cytology was suggestive of squamous cell carcinoma. The patient underwent surgical resection of the right submandibular gland and neck dissection. A malignant spindle cell proliferation involving the submandibular gland and colonizing one laterocervical lymph node was found. Morphology and immunophenotype prompted a differential diagnosis of a metastatic spindle cell melanoma versus an IDCS. Transmission electron microscopy was performed and supported a diagnosis of IDCS. The diagnosis of IDCS is a challenging task and may require a large array of techniques.
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Affiliation(s)
- Valentina Lupato
- />Department of Neurosciences, ENT Clinic and Regional Center for Head and Neck Cancer, Treviso Regional Hospital, University of Padua, Piazzale Ospedale 1, 31100 Treviso, Italy
| | - Salvatore Romeo
- />Department of Pathology, Treviso Regional Hospital, Treviso, Italy
| | - Alessandro Franchi
- />Section of Pathology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Monica Mantovani
- />Department of Neurosciences, ENT Clinic and Regional Center for Head and Neck Cancer, Treviso Regional Hospital, University of Padua, Piazzale Ospedale 1, 31100 Treviso, Italy
| | | | | | - Maria Cristina Da Mosto
- />Department of Neurosciences, ENT Clinic and Regional Center for Head and Neck Cancer, Treviso Regional Hospital, University of Padua, Piazzale Ospedale 1, 31100 Treviso, Italy
| | - Paolo Boscolo-Rizzo
- />Department of Neurosciences, ENT Clinic and Regional Center for Head and Neck Cancer, Treviso Regional Hospital, University of Padua, Piazzale Ospedale 1, 31100 Treviso, Italy
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28
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Rosenberg SA, Niglio SA, Jo VY, Goydos JS. Interdigitating dendritic cell sarcoma presenting in the skin: diagnosis and the role of surgical resection, chemotherapy and radiotherapy in management. Rare Tumors 2014; 6:5573. [PMID: 25568750 PMCID: PMC4274444 DOI: 10.4081/rt.2014.5573] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 08/29/2014] [Accepted: 09/03/2014] [Indexed: 11/23/2022] Open
Abstract
We report the case of an interdigitating dendritic cell sarcoma (IDCS) presenting in the skin. A 41-year old woman had a slowly enlarging mass on her right scapula that was excised multiple times under a presumptive diagnosis of a recurrent sebaceous cyst. However, the lesion was refractory to standard therapies. History and physical exam was unrevealing for any systemic signs or symptoms of disease. The patient’s metastatic work-up was negative. The lesion was resected with wide margins and was found to be consistent with IDCS. Patients that present with IDCS on the skin may present concurrently with metastatic disease and may have increased risk of secondary malignancies. The use of adjuvant chemoradiation after primary resection is controversial. However, the use of chemoradiation likely has benefit for local regional control for primary tumors that are unamendable to complete primary resection.
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Affiliation(s)
| | - Scot A Niglio
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai , New York, NY
| | - Vickie Y Jo
- Department of Pathology, Brigham and Women's Hospital , Boston, MA
| | - James S Goydos
- Department of Surgical Oncology, Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School , New Brunswick, NJ, USA
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29
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Dalia S, Jaglal M, Chervenick P, Cualing H, Sokol L. Clinicopathologic characteristics and outcomes of histiocytic and dendritic cell neoplasms: the moffitt cancer center experience over the last twenty five years. Cancers (Basel) 2014; 6:2275-95. [PMID: 25405526 PMCID: PMC4276966 DOI: 10.3390/cancers6042275] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 10/25/2014] [Accepted: 10/27/2014] [Indexed: 12/31/2022] Open
Abstract
Neoplasms of histiocytic and dendritic cells are rare disorders of the lymph node and soft tissues. Because of this rarity, the corresponding biology, prognosis and terminologies are still being better defined and hence historically, these disorders pose clinical and diagnostic challenges. These disorders include Langerhans cell histiocytosis (LCH), histiocytic sarcoma (HS), follicular dendritic cell sarcoma (FDCS), interdigtating cell sarcoma (IDCS), indeterminate cell sarcoma (INDCS), and fibroblastic reticular cell tumors (FRCT). In order to gain a better understanding of the biology, diagnosis, and treatment in these rare disorders we reviewed our cases of these neoplasms over the last twenty five years and the pertinent literature in each of these rare neoplasms. Cases of histiocytic and dendritic cell neoplasms diagnosed between 1989–2014 were identified using our institutional database. Thirty two cases were included in this analysis and were comprised of the following: Langerhans cell histiocytosis (20/32), histiocytic sarcoma (6/32), follicular dendritic cell sarcoma (2/32), interdigitating dendritic cell sarcoma (2/32), indeterminate dendritic cell sarcoma (1/32), and fibroblastic reticular cell tumor (1/32). Median overall survival was not reached in cases with LCH and showed 52 months in cases with HS, 12 months in cases with FDCS, 58 months in cases with IDCS, 13 months in the case of INDCS, and 51 months in the case of FRCT. The majority of patients had surgical resection as initial treatment (n = 18). Five patients had recurrent disease. We conclude that histiocytic and dendritic cell neoplasms are very rare and perplexing disorders that should be diagnosed with a combination of judicious morphology review and a battery of immunohistochemistry to rule out mimics such as carcinoma, lymphoma, neuroendocrine tumors and to better sub-classify these difficult to diagnose lesions. The mainstay of treatment for localized disease remains surgical resection and the role of adjuvant therapy is unclear. In patients with multiple areas of involvement, treatment at tertiary care centers with multimodality treatment is likely needed. Accurate subset diagnosis will contribute to better data as well as treatment outcomes analysis of these rare disorders of adult patients in the future.
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Affiliation(s)
- Samir Dalia
- Mercy Clinic Oncology and Hematology-Joplin, 3001 MC Clelland Park Blvd, Joplin, MO 64804, USA
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-417-782-7722
| | - Michael Jaglal
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33602, USA; E-Mails: (M.J.); (P.C.)
| | - Paul Chervenick
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33602, USA; E-Mails: (M.J.); (P.C.)
| | - Hernani Cualing
- IHCFLOW Histopathology Laboratory, University of South Florida, 18804 Chaville Rd., Lutz, FL 33558, USA; E-Mail:
| | - Lubomir Sokol
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33602, USA; E-Mails: (M.J.); (P.C.)
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30
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Ohtake H, Yamakawa M. Interdigitating dendritic cell sarcoma and follicular dendritic cell sarcoma: histopathological findings for differential diagnosis. J Clin Exp Hematop 2014; 53:179-84. [PMID: 24369219 DOI: 10.3960/jslrt.53.179] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Both interdigitating cell sarcoma (IDCS) and follicular dendritic cell sarcoma (FDCS) are rare neoplasms derived from dendritic cells in lymphoid organs. IDCS is defined as a neoplastic proliferation of spindle-shaped to ovoid cells with phenotypic features similar to those of IDCs. FDCS is a malignant neoplasm derived from FDCs that possess and present antigens to B cells in the follicular (germinal) centers of lymphoid organs. They often occur in lymph nodes, although they can also arise at extranodal sites. In this review, we have highlighted the morphological and immunohistochemical properties of these neoplasms, which could help in unequivocal and accurate diagnosis.
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Affiliation(s)
- Hiroya Ohtake
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine
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31
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32
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Hwang SO, Lee TH, Bae SH, Cho HD, Choi KH, Park SH, Kim CH, Kim SJ. Transformation of Castleman's disease into follicular dendritic cell sarcoma, presenting as an asymptomatic intra-abdominal mass. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2014; 62:131-4. [PMID: 23981949 DOI: 10.4166/kjg.2013.62.2.131] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Follicular dendritic cell (FDC) sarcoma is an extremely rare malignant neoplasm arising from FDCs. The exact origin of FDCs remains unclear; both a hematopoietic lineage origin and a stromal cell derivation have been proposed. Proliferation of FDCs can lead to benign reactive lesions or generate neoplastic conditions. The lesions are most commonly found in lymph nodes and usually involve the head and neck area. Castleman's disease is a rare non-neoplasitic lymphoproliferative disorder. Rare cases of hyaline-vascular Castleman's disease have been associated with FDC sarcoma, but a clonal relationship has not been convincingly demonstrated. A pathway toward tumor evolution, beginning with hyperplasia and dysplasia of FDCs, has been proposed. Despite this known association between Castleman's disease and FDC sarcoma, there have only been few reported cases of sarcoma arising as a complication of pre-existing Castleman's disease, especially in abdominal lesions. We describe here a 51-year-old female with an FDC sarcoma arising from unicentric, hyaline-vascular type Castleman's disease in an intra-abdominal mass. Pathologically, the lesion showed a series of changes during the process of transformation from Castleman's disease to FDC sarcoma. (Korean J Gastroenterol 2013;62:131-134).
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Affiliation(s)
- Soon Oh Hwang
- Department of Internal Medicine, Digestive Disease Center, Soonchunhyang University Hospital Cheonan, Soonchunhyang University College of Medicine, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 330-903, Korea
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O'Malley DP, Zuckerberg L, Smith LB, Barry TS, Gunn S, Tam W, Orazi A, Kim YS, Weiss LM. The genetics of interdigitating dendritic cell sarcoma share some changes with Langerhans cell histiocytosis in select cases. Ann Diagn Pathol 2013; 18:18-20. [PMID: 24321462 DOI: 10.1016/j.anndiagpath.2013.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 10/22/2013] [Indexed: 12/31/2022]
Abstract
Histiocytic disorders have been noted to have evidence of transdifferentiation; examples of cases with combinations of different lineages have been shown. In our index case, we identified interdigitating dendritic cell (IDC) differentiation in a case of Langerhans cell histiocytosis (LCH). Little is currently known about the genetics of IDC sarcoma (IDCS) because they are exceedingly rare. Using array comparative genomic hybridization (aCGH), we evaluated 4 cases of IDCS and compared them with our index case, as well as genetic abnormalities previously found in LCH. Four cases of paraffin-embedded samples of IDCS and 1 case of LCH with IDC differentiation were evaluated using aCGH. Array CGH results showed no abnormalities in a case of LCH with interdigitating cell differentiation. In 3 of 4 cases of IDCS, genetic abnormalities were identified; 1 case had no identifiable abnormalities. Interdigitating dendritic cell sarcoma case 1 had gains of 3q and 13q; IDCS case 2 had trisomy 12; IDCS case 3 had deletions of 7p, 12p, 16p, 18q, 19q, and 22q; and IDCS case 4 had no detectable abnormalities. Our index case, LCH with IDC differentiation, showed no abnormalities by aCGH. A number of LCH cases do not have detectable genetic abnormalities. In contrast, 3 of 4 cases of IDCS evaluated had identifiable abnormalities by aCGH. Furthermore, 2 of these shared abnormalities, albeit of large genetic regions, with published abnormalities seen in LCH. No recurrent abnormalities were identified in the IDCS cases. However, the possibility of a relationship between IDCS and LCH cannot be entirely excluded by these results.
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Affiliation(s)
- Dennis P O'Malley
- Clarient/GE Healthcare, Aliso Viejo, CA; MD Anderson Cancer Center/University of Texas, Houston, TX.
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34
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Joel F, Leong WM, Leong ASY. Essential Markers in Malignant Lymphoma: A Diagnostic Approach. J Histotechnol 2013. [DOI: 10.1179/his.2002.25.4.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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35
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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: 154] [Impact Index Per Article: 14.0] [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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36
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A rare case of interdigitating dendritic cell sarcoma in the nasal cavity. Case Rep Otolaryngol 2013; 2013:913157. [PMID: 23710400 PMCID: PMC3654715 DOI: 10.1155/2013/913157] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 04/03/2013] [Indexed: 12/30/2022] Open
Abstract
Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare neoplasm that mainly arises from the lymphoid tissues of the immune system. Although this neoplasm typically occurs anywhere along the lymph nodes, it can also be found at extranodal sites, especially in the head and neck. We experienced a rare case of extranodal IDCS in the nasal cavity, a location that has not been previously reported. A 73-year-old woman presented with a polyp-like mass in the nasal cavity and underwent endoscopic sinus surgery. A histologic study confirmed the mass as IDCS by immunohistochemistry with S-100 antibody, and postoperative adjuvant radiotherapy was administered. Although the incidence is extremely rare, this case suggests that extranodal IDCS should be considered in the differential diagnosis of nasal cavity masses.
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Jiang YZ, Dong NZ, Wu DP, Xue SL. Interdigitating dendritic cell sarcoma presenting simultaneously with acute myelomonocytic leukemia: report of a rare case and literature review. Int J Hematol 2013; 97:657-66. [PMID: 23605368 DOI: 10.1007/s12185-013-1336-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 04/09/2013] [Accepted: 04/11/2013] [Indexed: 12/18/2022]
Abstract
Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare tumor derived from interdigitating dendritic cells. We report the first case of a 64-year-old Chinese woman who was diagnosed with simultaneous IDCS and acute myelomonocytic leukemia (AML-M4). The patient had undergone chemotherapy for breast cancer 6 years previously. Based on the laboratory results, both the IDCS and the AML-M4 in this patient were determined to be of myelogenous origination. Furthermore, a review of 62 IDCS cases (Medline database, key word: IDCS) reported to date revealed that as many as 17 % of the patients had malignant disease and received radiotherapy and/or chemotherapy prior to developing IDCS, and that this group of patients showed worse prognosis compared with counterparts. The patient in the present report showed poor response to four cycles of sequential chemotherapy, and died 6 months after the initial diagnosis.
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Affiliation(s)
- Yi-Zhi Jiang
- Department of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China.
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38
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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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39
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Lee SY, Lee SR, Chang WJ, Kim HS, Kim BS, Kim IS. Successful treatment of disseminated interdigitating dendritic cell sarcoma with adriamycin, bleomycin, vinblastine, and dacarbazine chemotherapy. THE KOREAN JOURNAL OF HEMATOLOGY 2012; 47:150-3. [PMID: 22783364 PMCID: PMC3389066 DOI: 10.5045/kjh.2012.47.2.150] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 10/22/2011] [Accepted: 02/20/2012] [Indexed: 11/17/2022]
Abstract
Interdigitating dendritic cell sarcoma (IDCS) is a very rare and aggressive neoplasm that arises from antigen presenting cells. IDCS usually involves lymph nodes; however, extra-nodal involvement has also been reported. Because a consistent standard therapy for IDCS has not been established to date, we report a case of the successful treatment of disseminated IDCS using ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, and dacarbazine). A 64-year-old man was diagnosed with IDCS on the basis of immunohistochemical findings of a biopsy specimen of the inferior nasal concha. Immunohistochemical staining showed a positive reaction for CD68, leukocyte common antigen, and S-100 protein, but a negative reaction for CD34, CD1a, and CD21. Imaging studies showed cervical and axillary lymphadenopathies, subcutaneous nodules, and a soft tissue lesion in the nasal cavity. Treatment with the ABVD regimen resulted in complete remission after 8 cycles of chemotherapy.
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Affiliation(s)
- Suk-Young Lee
- Department of Hemato-oncology, Korea University Medical Center, Anam Hospital, Seoul, Korea
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40
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Black J, Coffin CM, Dehner LP. Fibrohistiocytic tumors and related neoplasms in children and adolescents. Pediatr Dev Pathol 2012; 15:181-210. [PMID: 22420728 DOI: 10.2350/11-03-1001-pb.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Fibrohistiocytic tumors (FHTs) in children and adolescents range from the benign fibrous histiocytoma, or dermatofibroma, to a variety of intermediate and malignant neoplasms, such as dermatofibrosarcoma protruberans and high-grade undifferentiated pleomorphic sarcoma (malignant fibrous histiocytoma). Those tumors as a group are comprised of fibroblasts, myofibroblasts, and histiocytes-dendritic cells with a variably prominent inflammatory infiltrate consisting of lymphocytes and eosinophils. Dendritic cells are also a major constituent of another group of neoplasms that include Langerhans cell histiocytosis, follicular and interdigitating cell sarcomas, and juvenile xanthogranuloma. These latter tumors are considered in this discussion for the sake of differential diagnosis and their possible histogenetic relationship to FHTs. Recent studies have suggested that the relationship between the fibroblast and histiocyte in the FHTs may reflect the intrinsic capacity to transdifferentiate from one to the other morphologic and functional state. The so-called "facultative fibroblast," as a cell with fibroblastic and histiocytic properties, was discussed in the context of the fibrous xanthoma 50 years ago. Possibly the entire histogenetic concept of FHTs should be reconsidered in light of current studies.
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Affiliation(s)
- Jennifer Black
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, USA.
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41
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Parada D, Peña KB, Gil I, Queralt R, Garcia A, Alos L. Interdigitating dendritic cell sarcoma presenting in the nasal region. Pathol Res Pract 2012; 208:368-71. [DOI: 10.1016/j.prp.2012.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 01/26/2012] [Accepted: 02/06/2012] [Indexed: 12/21/2022]
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Han SW, Kim ZS, Kim HM, Lee J, Kang GH, Cho HD, Kim SY, Park NK, Lim CW, Lee MH. Interdigitating dendritic cell sarcoma occured alone in axilla. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2012; 82:330-4. [PMID: 22563543 PMCID: PMC3341485 DOI: 10.4174/jkss.2012.82.5.330] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 12/07/2011] [Accepted: 12/22/2011] [Indexed: 12/18/2022]
Abstract
Interdigitating dendritic cell sarcoma (IDCS) is a very rare disease around the world and its prognosis is known to be aggressive. This reports a case diagnosed as IDCS of the axillary region treated in Soonchunhyang University Hospital. A 57-year-old female visited Soonchunhyang University Hospital with a left axillary mass. The mass was hard and fixed. Computed tomography observed a 7 cm lymph node at the left axilla, and core biopsy suspected sarcoma. In another study, there was no specific finding except the axillary lesion. Left axillary lymph node dissection (level I, II) was conducted and the pathologic report finally showed IDCS. The patient was treated with only radiotherapy and followed up without recurrence for 13 months up to now. IDCS is a very rare sarcoma that is hard to diagnose and progresses fast. Thus, treatment is very difficult. Proper treatment can be better established after more experiences.
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Affiliation(s)
- Sun Wook Han
- Department of Surgery, Soonchunhyang University College of Medicine, Cheonan, Korea
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43
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Mahamid A, Alfici R, Troitsa A, Anderman S, Groisman G, Zeina AR. Small intestine perforation due to metastatic uterine cervix interdigitating dendritic cell sarcoma: a rare manifestation of a rare disease. Rare Tumors 2011; 3:e46. [PMID: 22355501 PMCID: PMC3282451 DOI: 10.4081/rt.2011.e46] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Accepted: 09/25/2011] [Indexed: 02/01/2023] Open
Abstract
Interdigitating Dendritic Cell Sarcoma (IDCS) is an infrequent dendritic cell tumor which mainly affects the lymphatic system. Intestinal metastasis from uterine IDCS is extremely rare. Here we report a case of a 76-year-old female presenting with vaginal bleeding and acute abdomen. The final diagnosis revealed a small bowel perforation due to metastatic involvement from uterine cervix IDCS. In this paper, we report the clinical manifestation, computed tomography and histopathological findings helpful for the accurate diagnosis of this rare tumor.
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44
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Clonally related histiocytic/dendritic cell sarcoma and chronic lymphocytic leukemia/small lymphocytic lymphoma: a study of seven cases. Mod Pathol 2011; 24:1421-32. [PMID: 21666687 PMCID: PMC3175277 DOI: 10.1038/modpathol.2011.102] [Citation(s) in RCA: 137] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Histiocytic and interdigitating dendritic cell sarcomas are rare tumors originating from bone marrow-derived myeloid stem cells. Recent studies have shown evidence of cross-lineage transdifferentiation of B cells in follicular lymphoma to histiocytic and dendritic cell sarcomas. In this study, we report the morphologic, molecular and cytogenetic analysis of seven cases of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) associated with histiocytic and dendritic cell sarcomas. All seven patients were elderly males (median age 71 years). The B-cell neoplasms preceded the development of the histiocytic and dendritic cell sarcomas in six of seven patients, and one patient had both tumors diagnosed at the same time. The tumors included four interdigitating dendritic cell sarcomas: one Langerhans cell sarcoma, one histiocytic sarcoma and one immature neoplasm with evidence of histiocytic origin. Laser-capture microdissection and PCR analysis showed identical clonal immunoglobulin gene rearrangements in the two phenotypically distinct components in all cases. There was a preferential usage of IGHV4-39 by the V-D-J gene rearrangement. By fluorescence in situ hybridization (FISH) analysis, two cases showed deletion 17p in both components, whereas four cases had normal cytogenetic findings by FISH in the CLL/SLL cells, but acquired cytogenetic abnormalities in the corresponding histiocytic and dendritic tumors. Chromosome 17p abnormalities were the most common cytogenetic abnormality detected in the sarcomas, seen in five of six cases studied. Compared with the CLL/SLL cells, the histiocytic/dendritic cells were largely negative for PAX5, but showed strong expression of PU.1 and variable and weak expression of CEBPβ. Our study provides evidence for transdifferentiation of CLL/SLL B cells to tumors of dendritic and less often histiocytic lineage, and suggests that secondary genetic events may play a role in this phenomenon.
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45
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Han HS, Lee OJ, Lim SN, An JY, Lee KM, Choe KH, Lee KH, Kim ST. Extranodal interdigitating dendritic cell sarcoma presenting in the pleura: a case report. J Korean Med Sci 2011; 26:304-7. [PMID: 21286027 PMCID: PMC3031020 DOI: 10.3346/jkms.2011.26.2.304] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 10/27/2010] [Indexed: 12/12/2022] Open
Abstract
Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare neoplasm arising from the antigen-presenting cells of the immune system. This disease usually involves the lymph nodes, and rarely, extranodal sites may be affected. The authors report a case of extranodal IDCS presenting in the pleura. A 32-yr-old man presented with progressive chest pain. Imaging studies showed diffuse pleural thickening with pleural effusion. Morphological and immunohistochemical analysis of an incisional biopsy of the pleura were consistent with a diagnosis of IDCS; tumor cells were positive for S100 and CD45, but negative for CD1a, CD21, CD35, B cell and T cell markers. The patient was administered chemotherapy, but died of progressive disease. Although its incidence is extremely rare, this case suggests that extranodal IDCS should be considered in the differential diagnosis of undifferentiated neoplasms and that immunohistochemical staining be performed using appropriate markers.
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Affiliation(s)
- Hye-Suk Han
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ok-Jun Lee
- Department of Pathology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sung-nam Lim
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jin Young An
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ki Man Lee
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Kang Hyeon Choe
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ki Hyeong Lee
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Seung Taik Kim
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
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46
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Zhou J, Zhou W, Bai C, Zhou Y, Wang Y. Interdigitating Dendritic Cell Sarcoma: Case Report with Review of the Literature. ACTA ACUST UNITED AC 2011; 34:634-7. [DOI: 10.1159/000334212] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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47
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Abstract
This article reviews the features of dendritic cells (DCs) of myeloid-derived, plasmacytoid, and follicle-associated types and tumors of these cells, as well as myeloid sarcoma. The morphologic and immunophenotypic features in this group of neoplasms is featured, including mature neoplasms such as Langerhans cell histiocytosis, its malignant counterpart Langerhans cell sarcoma, and S100-negative histiocytic proliferations. More immature or precursor malignancies in this group include myeloid and monocytic leukemias presenting in extramedullary tissues as well as the newly codified blastic plasmacytoid dendritic cell neoplasm. Although likely not related histogenetically to myeloid-derived DCs, mesenchymal-type lymph node tumors including follicular dendritic cell and fibroblastic reticulum sarcomas are also discussed. All of these neoplasms can exhibit a range of immunophenotypic and morphologic features that underscore the plasticity of the non-neoplastic precursors from which they are derived.
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Affiliation(s)
- Dan Jones
- Quest Diagnostics Nichols Institute, 14207 Newbrook Drive, Chantilly, VA 20153, USA.
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48
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Liu X, Deng Y, Zhang X, Mukherjee R, Huang W, Zhang G, Wang H, Li X. Interdigitating dendritic cell sarcoma following adult liver transplantation: case report and literature review. Pathol Oncol Res 2010; 17:397-402. [PMID: 21052884 DOI: 10.1007/s12253-010-9312-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2010] [Accepted: 10/01/2010] [Indexed: 12/24/2022]
Abstract
Interdigitating dendritic cell sarcoma is an extremely rare neoplasm derived from professional antigen presenting cells. We report an unusual case of such a tumor occurring in a 61-year-old woman who had undergone orthotopic liver transplantation for stage IVA2 primary hepatocellular carcinoma with a raised preoperative α-fetoprotein level, followed by tacrolimus-based immunosuppressive therapy. During her subsequent management, the tacrolimus blood levels ranged from 7.9 ng/mL to 16.1 ng/mL. Physical examination revealed bilateral neck and left axillary lymphadenopathy. No evidence of either chronic hepatitis B virus or Epstein-Barr virus could be detected in serum. An excisional biopsy of a right neck lymph node was performed. Microscopically, the normal architecture was diffusely effaced by a proliferation of spindled to ovoid cells arrayed in a fascicular, ill-defined whorled pattern and small lymphocytes were admixed in varying numbers with the tumor cells. Immunohistochemical studies showed that the tumor cells were positive for S100 protein, vimentin and CD68. Based on these findings, the case was diagnosed as an interdigitating dendritic cell sarcoma. The patient unfortunately had no response to 2 cycles of CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone), and died of wide spread disease 6 months after the original biopsy. We propose that tacrolimus-based immunosuppression was associated with the development of interdigitating dendritic cell sarcoma after liver transplantation in this case.
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Affiliation(s)
- Xi Liu
- Department of Pathology, First Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an 710061, China.
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49
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Weiss GJ, Alarcon A, Halepota M, Penny RJ, Von Hoff DD. Molecular characterization of interdigitating dendritic cell sarcoma. Rare Tumors 2010; 2:e50. [PMID: 21139965 PMCID: PMC2994531 DOI: 10.4081/rt.2010.e50] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Accepted: 07/22/2010] [Indexed: 11/22/2022] Open
Abstract
Interdigitating dendritic cell sarcoma is an extremely rare cancer that lacks a standard treatment approach. We report on a patient who was surgically resected and remains disease- free. The tumor was assessed for druggable targets using immunohistochemical staining to identify potential agents that could be used in the event of disease recurrence.
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Affiliation(s)
- Glen J Weiss
- Virginia G. Piper Cancer Center at Scottsdale Healthcare, Scottsdale, USA
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50
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KIM SY, KANG JH, CHUN SH, CHANG MH, KIM YS, LEE SN, KIM MS, KANG CS. Interdigitating dendritic cell sarcoma of the tonsil. Asia Pac J Clin Oncol 2010; 6:144-8. [DOI: 10.1111/j.1743-7563.2010.01298.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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