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Prasad AS, Chua SS, Ramani NS, Shiralkar KG, Shanbhogue KP, Surabhi VR. Stroma-derived neoplasms and pseudoneoplastic lesions of the spleen: a select review of pathologic and CT/MRI findings. Abdom Radiol (NY) 2024:10.1007/s00261-024-04461-y. [PMID: 38937338 DOI: 10.1007/s00261-024-04461-y] [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: 04/07/2024] [Revised: 06/09/2024] [Accepted: 06/15/2024] [Indexed: 06/29/2024]
Abstract
A wide spectrum of benign and malignant primary mesenchymal tumors and tumor-like lesions of the spleen has been recently included under the umbrella term 'stroma-derived' neoplasms and tumor-like lesions. These include dendritic cell neoplasms such as follicular dendritic cell sarcoma, EBV-positive inflammatory follicular dendritic cell sarcoma, and fibroblastic reticular cell tumor; smooth muscle and myofibroblastic lesions such as inflammatory pseudotumor, EBV-associated smooth muscle tumor and undifferentiated pleomorphic sarcoma as well as a diverse spectrum of vascular and vascular-stromal tumors and tumor-like lesions. While some tumor and tumor-like lesions are unique to the spleen, others may also occur in diverse extra-splenic viscera. These tumors and tumor-like lesions demonstrate characteristic histopathology, immunocytochemistry and biological behavior. While cross-sectional imaging studies allow detection, staging and limited characterization of these splenic lesions, histopathological confirmation permits optimal management and surveillance strategies.
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Affiliation(s)
- Aditya S Prasad
- Departments of Radiology, University of Texas MD Anderson Cancer Center, Houston, USA
| | | | - Nisha S Ramani
- Department of Pathology, Michael E DeBakey VA Medical Center, Houston, USA
| | | | | | - Venkateswar R Surabhi
- Departments of Radiology, University of Texas MD Anderson Cancer Center, Houston, USA.
- Department of Abdominal Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX, 77030, USA.
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Gil A, Castrejon-de-Anta N, Vilaseca I, Frigola G, Campo E, Oleaga L. Laryngeal EBV-positive Inflammatory Follicular Dendritic cell/fibroblastic Reticular cell Tumour. Indian J Otolaryngol Head Neck Surg 2023; 75:3941-3944. [PMID: 37974680 PMCID: PMC10646119 DOI: 10.1007/s12070-023-03937-5] [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: 02/19/2023] [Accepted: 06/02/2023] [Indexed: 11/19/2023] Open
Abstract
Epstein-Barr virus-positive Inflammatory follicular dendritic cell/fibroblastic reticular cell tumour (EBV-IFDC/FRCT) is a rare neoplasm that occurs almost exclusively in the liver or spleen. Extra-hepatosplenic presentation is infrequent and exceptional cases have been described arising in the gastrointestinal tract or in the pharynx. However, EBV-IFDC/FRCT cases have not been previously reported in the larynx. This report describes a case of a 32-year-old woman who arrived to the emergency department due to progressive dyspnea with associated inspiratory stridor and non-productive cough. Direct laryngoscopy showed a nodular tumour arising on the left posterior subglottic mucosa obstructing 90% of the airway. A preoperative dual energy contrast enhanced computed tomography (CECT) was performed demonstrating a low attenuation lesion on virtual non-contrast (VNC) images and vivid iodine uptake on the iodine map. The tumour was excised and the histopathological analysis led to the diagnosis of an EBV-IFDC/FRCT. A fibre-optic laryngoscopy six months after the surgery did not show any abnormalities. Although the vast majority of EBV-IFDC/FRCT occur in the liver or spleen, some extra hepatosplenic tumours have been reported affecting the head and neck region. We describe here the first case arising in the larynx, as well as the usefulness of preoperative dual energy imaging techniques to assess these lesions, thus providing information that could have management implications.
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Affiliation(s)
- Alex Gil
- Radiology Department of Hospital Clínic Barcelona, Barcelona, Spain
| | | | - Isabel Vilaseca
- Functional Unit of Head Neck Tumors. Hospital Clínic Barcelona, Barcelona, Spain
- Department of Surgery. School of Medicine. University of Barcelona, Barcelona, Spain
| | - Gerard Frigola
- Pathology Department of Hospital Clínic Barcelona, Villarroel 170, Barcelona, 08036 Spain
| | - Elias Campo
- Pathology Department of Hospital Clínic Barcelona, Villarroel 170, Barcelona, 08036 Spain
| | - Laura Oleaga
- Radiology Department of Hospital Clínic Barcelona, Barcelona, Spain
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3
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Li X, Gu J, He Q, Han S, Wu H. Pancreatic follicular dendritic cell sarcoma: a rare case report and systematic literature review of 7 cases. World J Surg Oncol 2023; 21:212. [PMID: 37480085 PMCID: PMC10360331 DOI: 10.1186/s12957-023-03115-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/13/2023] [Indexed: 07/23/2023] Open
Abstract
INTRODUCTION Pancreatic follicular dendritic cell sarcoma (FDCS) is an exceptionally rare and low-to-moderate malignancy, with only seven reported cases to date. Clinical diagnosis of FDCS is challenging due to the lack of distinct biological and radiographic features. CASE PRESENTATION A 67-year-old woman presented to the hospital with a 4-day history of severe abdominal pain. Imaging studies (CT and MRI) revealed a large cystic mass located at the tail of the pancreas, which was suspected to be myeloid sarcoma (MS) based on EUS and CT-guided pancreatic puncture. Postoperative pathology and immunohistochemistry confirmed the diagnosis of pancreatic FDCS. After the diagnosis was confirmed, the patient received postoperative chemotherapy with the CHOP regimen. At 11 months of follow-up, there was no evidence of recurrence. Seven published cases have been reviewed to comprehensively summarize the clinical characteristics, diagnosis, and treatment options of FDCS. CONCLUSION While imaging can be useful in detecting pancreatic FDCS, it should be interpreted with caution as it can be challenging to differentiate from other pancreatic tumors. Pathology and immunohistochemistry are considered the gold standard for diagnosis, with CD21, CD23, and CD35 being specific tumor cell markers. However, preoperative diagnosis of pancreatic FDCS remains difficult, and the pancreatic puncture may further increase the risk of misdiagnosis. The disease is highly prone to recurrence and metastasis, and surgery is the preferred method for both diagnosis and treatment of localized disease.
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Affiliation(s)
- Xu Li
- Department of Gastroenterology, Digestive Disease Hospital, The Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, People's Republic of China
| | - Jin Gu
- Department of General Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, People's Republic of China
| | - Qingyun He
- Department of Gastroenterology, Digestive Disease Hospital, The Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, People's Republic of China
| | - Shuwen Han
- Department of Gastroenterology, Digestive Disease Hospital, The Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, People's Republic of China
| | - Huichao Wu
- Department of Gastroenterology, Digestive Disease Hospital, The Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, People's Republic of China.
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Gui H, Chaudhari J, Mannan R. Follicular dendritic cell sarcoma of gastrointestinal tract with two emerging distinct subtypes: a case report and systemic review. Diagn Pathol 2022; 17:64. [PMID: 35941667 PMCID: PMC9358870 DOI: 10.1186/s13000-022-01246-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 07/22/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm of mesenchymal origin. FDCS of gastrointestinal tract (GI) are exceedingly uncommon. CASE PRESENTATION We report the first case of classic type FDCS in a 34-year-old male with Birt-Hogg-Dubé syndrome, which presented as a mass at the ileo-cecal junction. He received no further treatment after resection and remained disease free for 3.5 years. We further analyze and review the clinical and pathologic findings of 33 cases of GI tract FDCS reported in the literature. CONCLUSIONS There are two distinct subtypes of FDCS in the GI tract: the classic type occurs in relatively younger patients (mean = 45.3 years) without Epstein-Barr virus (EBV) association, and behaves more aggressively; the inflammatory subtype presents as colonic polypoid tumor in older patients (mean = 60.7 years) and is EBV positive. The clinical outcome in the latter group appears favorable although mortality rate is not necessarily low.
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Affiliation(s)
- Hongxing Gui
- Department of Pathology and Laboratory Medicine, Pennsylvania Hospital of the University of Pennsylvania Health System, 801 Spruce Street, 10th Floor Spruce building, Philadelphia, PA, 19107, USA.
| | - Jigisha Chaudhari
- Department of Pathology and Laboratory Medicine, Pennsylvania Hospital of the University of Pennsylvania Health System, 801 Spruce Street, 10th Floor Spruce building, Philadelphia, PA, 19107, USA
| | - Rifat Mannan
- Department of Pathology and Laboratory Medicine, Pennsylvania Hospital of the University of Pennsylvania Health System, 801 Spruce Street, 10th Floor Spruce building, Philadelphia, PA, 19107, USA
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Rajan R, Roshni DG, Mathew SM, Jojo A, Nair HM, Kottarathil VD. Follicular dendritic cell sarcoma of the thigh: a clinicopathological report and management approach. BMJ Case Rep 2022; 15:e244812. [PMID: 35473698 PMCID: PMC9045049 DOI: 10.1136/bcr-2021-244812] [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] [Accepted: 03/23/2022] [Indexed: 11/04/2022] Open
Abstract
Follicular dendritic cells are antigen-presenting immune accessory cells of mesenchymal origin. Follicular dendritic cell sarcomas (FDCS) typically occur in nodal and extranodal sites. However, presentation in the extremity has rarely been reported. A woman in her 60s had a painless, slow-growing right posterior thigh swelling, which had been present for 9 months. Imaging revealed a subcutaneous lesion in the posterior aspect of the right mid-thigh. Fine-needle aspiration cytology from the lesion was suggestive of a malignant spindle cell neoplasm, and she underwent its wide local excision. Immunohistochemistry showed expression of epithelial membrane antigen and CD35, but an absence of cytokeratin, desmin, CD23 and S100. The Ki-67 index was low and a diagnosis of FDCS was made. The lack of clinical guidelines was a challenge in the treatment of this rare case. A multidisciplinary board discussion played a critical role in the planning of the patient's adjuvant treatment.
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Affiliation(s)
- Rajasree Rajan
- Radiation Oncology, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
| | - Divya Gireesan Roshni
- Radiation Oncology, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
| | | | - Annie Jojo
- Pathology, Amrita Institute of Medical Sciences, Cochin, Kerala, India
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Follicular Dendritic Cell Sarcomas: CT and MRI Findings in 20 Patients. AJR Am J Roentgenol 2021; 216:835-843. [PMID: 33405946 DOI: 10.2214/ajr.19.22759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. The objective of this study was to assess the imaging features of follicular dendritic cell sarcoma (FDCS) on CT and MRI. MATERIALS AND METHODS. The clinical data and pretreatment findings of 20 patients with pathologically proven FDCS on CT (n = 15), MRI (n = 7), or both (n = 2) were analyzed retrospectively. Tumor location, number, size, morphology, attenuation or signal intensity, margin, presence of metastases, and contrast enhancement were evaluated. RESULTS. FDCS originated from lymph nodes (n = 6) or a variety of extranodal sites (n = 14). The tumors were typically solitary and well-circumscribed. Extranodal lesions (mostly in the abdomen or mediastinum with mean diameter, 11.8 cm) were larger than nodal lesions (mean diameter, 6.5 cm). Nodal-type cases presented with homogeneous masses on CT and MRI. However, on CT, all extranodal tumors (n = 12) showed heterogeneous attenuation, of which 91.7% (11/12) contained areas of lower attenuation because of internal necrosis and 50.0% (6/12) showed calcifications. On MRI, primary hepatic or splenic tumors (n = 3) also appeared as large heterogeneous masses. Seven patients (35.0%) had advanced-stage disease, and intraabdominal extranodal cases were more likely to have regional lymphadenopathy (n = 4) and distant metastases (n = 5). Hypervascularity was seen in 90.0% (18/20) of patients and progressive enhancement was seen in 11 (78.6%) of 14 tumors with multiphase imaging. CONCLUSION. FDCS is a rare, mostly solitary, well-delineated malignancy. A nodal-type FDCS typically presents as a small homogeneous mass, whereas an extranodal FDCS in the mediastinum or abdomen manifests as a large heterogeneous mass with internal necrosis and calcifications accompanied by regional lymphadenopathy. Hypervascularity and progressive enhancement can be seen in the majority of tumors.
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Wu YL, Wu F, Xu CP, Chen GL, Zhang Y, Chen W, Yan XC, Duan GJ. Mediastinal follicular dendritic cell sarcoma: a rare, potentially under-recognized, and often misdiagnosed disease. Diagn Pathol 2019; 14:5. [PMID: 30646936 PMCID: PMC6334468 DOI: 10.1186/s13000-019-0779-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 01/02/2019] [Indexed: 12/17/2022] Open
Abstract
Background Mediastinal follicular dendritic cell sarcoma (FDCS) is extremely rare. Due to potential under-recognization of this disease, it happens to be misdiagnosed, especially on core needle biopsy. We report 3 cases of mediastinal FDCS and provide a literature review to improve better understanding of the tumor and to reduce misdiagnosis. Methods Three cases of mediastinal FDCS in our clinic practice were studied, including their core needle biopsy and resected specimens, and those cases reported previously in English literature were retrieved and analyzed. Results The core needle biopsy of case 1 showed a tumor reminiscent of classical Hodgkin’s lymphoma (CHL), while the resected mass was finally diagnosed with FDCS combined with hyaline-vascular Castleman’s disease. Both the biopsy and resected tissue of case 2 were constitutive of the clear epithelioid cells with marked atypia. In both cases, definitive diagnoses were not made on core needle biopsy. In case 3, there were some areas morphologically similar to CHL, and some areas contained ovoid to spindle-shaped tumor cells with fascicular pattern. The analysis of 43 cases of mediastinal FDCS showed the age of patients were from 16 to 76 years old, the male to female ratio was 1.5:1, the maximal tumor diameters were 3–17 cm. 18 cases were underwent preoperative biopsy, whereas 15 (83.3%) of which were misdiagnosed initially, often as lymphoma. 32 patients had available follow-up data, the rates of recurrence, metastasis, and mortality were 12.5, 18.8 and 28.1%, respectively. Current limited data suggested no statistical differences between adverse prognosis and gender, age, tumor size, necrosis, or different therapeutics, respectively. Conclusions Mediastinal FDCS is a rare malignancy that has yet not been fully understood and been often misdiagnosed, particularly when making a diagnosis on core needle biopsy. Increased awareness of this enigmatic tumor is crucial to avoid diagnostic pitfalls.
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Affiliation(s)
- You-Li Wu
- Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Feng Wu
- Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Cheng-Ping Xu
- Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Guo-Lei Chen
- Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Yu Zhang
- Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Wei Chen
- Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Xiao-Chu Yan
- Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
| | - Guang-Jie Duan
- Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
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Unusual Presentation of Follicular Dendritic Cell Sarcoma as a Cystic Neck Swelling. Case Rep Oncol Med 2018; 2018:4038250. [PMID: 30473898 PMCID: PMC6220415 DOI: 10.1155/2018/4038250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 10/09/2018] [Indexed: 01/05/2023] Open
Abstract
Follicular dendritic cell sarcoma is a very rare neoplasm that most commonly involves cervical lymph nodes and usually presents as a solid mass. Presentation as a cystic neck mass is very rare. Radiological studies and aspiration cytology are often unreliable, and diagnosis is usually made after thorough clinical and pathological examination along with immunohistochemical analysis. In this article, we report a case of a 42-year-old man who presented with right-sided neck swelling of a 2-month duration. Contrast-enhanced CT showed a cystic lesion in the right side of the neck inferomedial to parotid gland located between medial border of sternocleidomastoid muscle and internal jugular vein. Fine needle aspiration cytology was inconclusive. Patient underwent excision biopsy. Histological examination showed a solid-cystic tumor composed of spindle cells arranged in storiform pattern and showed a positive staining for CD23, CD35, and CD21 that confirmed the diagnosis of follicular dendritic cell sarcoma.
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Urun Y, Kankaya D, Koral L, Yalcin B, Karabork A, Ceyhan K, Boruban MC, Utkan G, Demirkazik A. Intraabdominal Follicular Dendritic Cell Sarcoma: A Report of Three Cases and Review of the Literature. TUMORI JOURNAL 2018; 99:e65-9. [DOI: 10.1177/030089161309900231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm that originates from follicular dendritic cells in lymphoid follicles. FDCS has been increasingly reported in recent years. However, data on FDCS are mostly based on single case reports or case series and its natural history and standard treatment are not clear. To increase the understanding of this rare disease, we report our experience of three cases of FDCS with an analysis of the morphological and immunophenotypic characteristics, clinical course, treatment options and response to treatment. In addition, we reviewed the literature on FDCS.
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Affiliation(s)
- Yuksel Urun
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara
| | - Duygu Kankaya
- Department of Medical Pathology, Ankara University Faculty of Medicine, Ankara
| | - Lokman Koral
- Department of Medical Oncology, Selcuk University Meram Faculty of Medicine, Konya
| | - Bulent Yalcin
- Department of Medical Oncology, Yildirim Beyazit University Faculty of Medicine, Atatürk Research and Educational Hospital, Ankara, Turkey
| | - Ayca Karabork
- Department of Medical Pathology, Ankara University Faculty of Medicine, Ankara
| | - Koray Ceyhan
- Department of Medical Pathology, Ankara University Faculty of Medicine, Ankara
| | - Melih Cem Boruban
- Department of Medical Oncology, Selcuk University Meram Faculty of Medicine, Konya
| | - Gungor Utkan
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara
| | - Ahmet Demirkazik
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara
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Hu J, Dong D, Jiang Z, Hu H. Clinicopathological characteristics of mediastinal follicular dendritic cell sarcoma: report of three cases. J Cardiothorac Surg 2016; 11:56. [PMID: 27068522 PMCID: PMC4828768 DOI: 10.1186/s13019-016-0464-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 04/05/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Follicular dendritic cell sarcoma (FDCS) is a rare malignant neoplasm of follicular dendritic cells that form a tight meshwork within lymphoid follicles. It occurs most commonly in the lymph nodes and occasionally at extranodal sites, but rarely in the mediastinum. It is an under-recognized clinical entity without clear diagnosis. Due to its rarity, FDCS is easily misdiagnosed by clinicians or pathologists. CASE PRESENTATION Herein, we report three unusual cases of mediastinal FDCS, including one with hyaline vascular Castleman's disease in woman. The clinicopathological characteristics and CT imagings were described. Their diagnosis was confirmed by immunohistochemical stainings of specific markers. Their therapeutic intervention, follow-up and outcomes were presented with brief literature review. CONCLUSIONS A huge mediastinal shallowly-lobulated, demarcated soft tissue mass, with speckled, strip-like, coarse or arborizing calcification inside, and mild to moderate enhancement after contrast material administration on CT image, should consider FDCS as a possible diagnosis.
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Affiliation(s)
- Jibo Hu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China.
| | - Danjun Dong
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
| | - Zhinong Jiang
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
| | - Hongjie Hu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
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Li J, Geng ZJ, Xie CM, Zhang XK, Chen RY, Cai PQ, Lv XF. Computer Tomography Imaging Findings of Abdominal Follicular Dendritic Cell Sarcoma: A Report of 5 Cases. Medicine (Baltimore) 2016; 95:e2404. [PMID: 26735543 PMCID: PMC4706263 DOI: 10.1097/md.0000000000002404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Follicular dendritic cell sarcoma (FDCS) is a neoplasm that arises from follicular dendritic cells. FDCSs originating in the abdomen are extremely rare. Clinically, they often mimic a wide variety of other abdominal tumors, and correct preoperative diagnosis is often a challenging task. To date, only scattered cases of abdominal FDCS have been reported and few data are available on their radiological features. Here we present the computer tomography imaging findings of 5 patients with surgically and pathologically demonstrated abdominal FDCS. An abdominal FDCS should be included in the differential diagnosis when single or multiple masses with relatively large size, well- or ill-defined borders, complex internal architecture with marked internal necrosis and/or focal calcification, and heterogeneous enhancement with "rapid wash-in and slow wash-out" or "progressive enhancement" enhancement patterns in the solid component are seen.
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Affiliation(s)
- Jing Li
- From the Department of Medical Imaging (JL, Z-JG, C-MX, P-QC, X-FL), Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center; Department of Pathology (X-KZ), Sun Yat-sen University Cancer Center; and Department of Medical Imaging Center (R-YC), NanFang Hospital, Southern Medical University, Guangzhou, PR China
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Ma Y, Sun J, Yang C, Yuan D, Liu J. Follicular dendritic cell sarcoma: two rare cases and a brief review of the literature. Onco Targets Ther 2015; 8:1823-30. [PMID: 26244020 PMCID: PMC4521670 DOI: 10.2147/ott.s86502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare malignant tumor recognized in recent years. It accounts for only 0.4% of soft-tissue sarcomas, and its underlying causes are largely unknown. A correct diagnosis can be difficult to make. Diagnosis of FDCS depends on the combined clinical examination, histopathologic features, electron microscopic examination and confirmation with immunohistochemical studies. Here, we report two rare cases of FDCS: one case involving multiple bones, and the other involving extensive abdominal and pelvic cavities. Clinical, histopathological, and immunohistochemical aspects, therapeutic options, and a related literature review of the two cases are discussed. As the prevalence of FDCS is increasing, the details of these rare cases may highlight the importance and facilitate treatment of similar diseases.
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Affiliation(s)
- Yuan Ma
- Department of Oncology, Shandong Cancer Hospital & Institute, School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Shandong Province, People's Republic of China
| | - Jujie Sun
- Department of Pathology, Shandong Cancer Hospital & Institute, Jinan, Shandong Province, People's Republic of China
| | - Cuicui Yang
- Department of Oncology, Shandong Cancer Hospital & Institute, School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Shandong Province, People's Republic of China
| | - Dandan Yuan
- Department of Oncology, Shandong Cancer Hospital & Institute, Jinan, Shandong Province, People's Republic of China
| | - Jie Liu
- Department of Oncology, Shandong Cancer Hospital & Institute, Jinan, Shandong Province, People's Republic of China
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Li J, Zhou ML, Zhou SH. Clinical and pathological features of head and neck follicular dendritic cell sarcoma. Hematology 2015; 20:571-83. [PMID: 25831474 DOI: 10.1179/1607845415y.0000000008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Ji Li
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003 Zhejiang Province, China
- Department of Otolaryngology, The First people's Hospital of Ningbo City, 315010 Zhejiang Province, China
| | - Min-Li Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003 Zhejiang Province, China
| | - Shui-Hong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003 Zhejiang Province, China
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Yuan T, Yang Q, Zhang H, Li J, Zhang X. A 46-year-old Chinese woman presenting with retroperitoneal follicular dendritic cell sarcoma: a case report. J Med Case Rep 2014; 8:113. [PMID: 24708915 PMCID: PMC3977978 DOI: 10.1186/1752-1947-8-113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 02/05/2014] [Indexed: 01/28/2023] Open
Abstract
Introduction Follicular dendritic cells are non-phagocytic, non-lymphoid cells of the immune system that are necessary for antigen presentation and the regulation of reactions in the germinal centers of the lymph nodes. Follicular dendritic cell sarcoma is an unusual cancer, particularly in the intra-abdominal region. In the present report we describe an unusual case of retroperitoneal follicular dendritic cell sarcoma that emphasizes the difficulty of diagnosing and treating this tumor. Retroperitoneal follicular dendritic cell sarcoma has only been rarely reported in the literature to date. Case presentation A 46-year-old Chinese woman of Han ethnicity presented with chronic right lower quadrant abdominal pain over the preceding 4 weeks. The tumor was resected and submitted to histopathological examination. The case was verified as retroperitoneal follicular dendritic cell sarcoma by microscopic examination and immunohistochemical analysis. After diagnosis, she received postoperative radiotherapy and chemotherapy. She has survived 3 years postoperatively, although she has a pulmonary metastasis. Conclusions Retroperitoneal follicular dendritic cell sarcoma may demonstrate aggressive potential. This study indicated that postoperative adjuvant radiotherapy and chemotherapy could extend the survival of a patient with retroperitoneal follicular dendritic cell sarcoma.
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Affiliation(s)
| | | | | | | | - Xiuping Zhang
- Department of Radiation Oncology, Affiliated Tumor Hospital, Guangzhou Medical University, No,78 Hengzhigang, Road, Guangzhou, Guangdong Province 510095, China.
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Saygin C, Uzunaslan D, Ozguroglu M, Senocak M, Tuzuner N. Dendritic cell sarcoma: a pooled analysis including 462 cases with presentation of our case series. Crit Rev Oncol Hematol 2013; 88:253-71. [PMID: 23755890 DOI: 10.1016/j.critrevonc.2013.05.006] [Citation(s) in RCA: 157] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 03/16/2013] [Accepted: 05/08/2013] [Indexed: 02/06/2023] Open
Abstract
Dendritic cell tumors are extremely rare and current knowledge on these tumors is limited. The characteristics of three dendritic cell sarcoma subtypes and their optimal treatment approaches are not fully clarified. We aimed to make a systematic review of the literature and enrich the current data with five new cases. Pooled analysis of 462 reported cases revealed that the tumor had no age, gender or racial predilection. Our analysis suggests that the young age, advanced stage, intraabdominal involvement and unfavorable histological features (i.e. large tumor size, absence of lymphoplasmacytic infiltration, coagulative necrosis, high mitotic count) may predict poor prognosis. Subtypes of this tumor have different clinical behaviors with interdigitating dendritic cell sarcoma being the most aggressive form. In general, surgery is the most effective treatment modality and adjuvant radiotherapy has no significant effect on overall survival of patients. The role of chemotherapy for the management of advanced disease is controversial.
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Affiliation(s)
- Caner Saygin
- Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
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Kim H, Park CM, Jeon YK, Paeng JC, Goo JM, Lee HJ. Follicular dendritic cell sarcoma of the mediastinum: CT and 18 F-fluoro-2-deoxyglucose PET findings. Thorac Cancer 2013; 4:203-206. [PMID: 28920202 DOI: 10.1111/j.1759-7714.2012.00143.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Mediastinal follicular dendritic cell sarcoma (FDCS) is an exceedingly rare malignant tumor. We report, herein, detailed imaging findings of mediastinal FDCS, appearing as a large, well-circumscribed, strongly enhancing mass with central coarse calcification on computed tomography, with moderately increased metabolic activity on 18 F-fluoro-2-deoxyglucose positron emission tomography.
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Affiliation(s)
- Hyungjin Kim
- Department of Radiology, Seoul National University College of Medicine, and Cancer Research Institute, Seoul National University, Seoul, KoreaDepartment of Pathology, Seoul National University College of Medicine, Seoul, KoreaDepartment of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Min Park
- Department of Radiology, Seoul National University College of Medicine, and Cancer Research Institute, Seoul National University, Seoul, KoreaDepartment of Pathology, Seoul National University College of Medicine, Seoul, KoreaDepartment of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Kyung Jeon
- Department of Radiology, Seoul National University College of Medicine, and Cancer Research Institute, Seoul National University, Seoul, KoreaDepartment of Pathology, Seoul National University College of Medicine, Seoul, KoreaDepartment of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Chul Paeng
- Department of Radiology, Seoul National University College of Medicine, and Cancer Research Institute, Seoul National University, Seoul, KoreaDepartment of Pathology, Seoul National University College of Medicine, Seoul, KoreaDepartment of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, and Cancer Research Institute, Seoul National University, Seoul, KoreaDepartment of Pathology, Seoul National University College of Medicine, Seoul, KoreaDepartment of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun-Ju Lee
- Department of Radiology, Seoul National University College of Medicine, and Cancer Research Institute, Seoul National University, Seoul, KoreaDepartment of Pathology, Seoul National University College of Medicine, Seoul, KoreaDepartment of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
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19
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Chien JCW, Lao WT, Chen CL, Chan WP. Follicular dendritic cell sarcoma of the omentum: multidetector computed tomography findings. Korean J Radiol 2013; 14:213-7. [PMID: 23483068 PMCID: PMC3590332 DOI: 10.3348/kjr.2013.14.2.213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 03/19/2012] [Indexed: 02/06/2023] Open
Abstract
We report computed tomography (CT) findings for a rare case of follicular dendritic cell sarcoma of the greater omentum from a 47-year-old female patient. The tumor presented ash a palpable mass lesion in the umbilical region for the last two months. Multidetector CT scan of the abdomen showed a 14-cm soft-tissue mass with calcification and necrosis within the greater omentum. As a result, a follicular dendritic cell sarcoma should be considered in the differential diagnosis of a solitary omentum mass, especially one with coarse and chunk-like calcifications.
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Affiliation(s)
- Jerry Chin-Wei Chien
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
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Shinagare AB, Ramaiya NH, Jagannathan JP, Hornick JL, Swanson RS. Primary follicular dendritic cell sarcoma of liver treated with cyclophosphamide, doxorubicin, vincristine, and prednisone regimen and surgery. J Clin Oncol 2011; 29:e849-51. [PMID: 22042944 DOI: 10.1200/jco.2011.37.1906] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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21
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Schraven SP, Plontke SK, Syha R, Fend F, Wolburg H, Adam P. Dendritic cell tumor in a salivary gland lymph node: a rare differential diagnosis of salivary gland neoplasms. Diagn Pathol 2011; 6:94. [PMID: 21961558 PMCID: PMC3216896 DOI: 10.1186/1746-1596-6-94] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 09/30/2011] [Indexed: 01/02/2023] Open
Abstract
Dendritic cell tumors are extremely rare neoplasms arising from antigen-presenting cells of the immune system. We report a case of a 69-year-old man with an unremarkable medical history who presented with a 2-months history of a gradually enlarging painless, firm, mobile, 2 × 2-cm swelling at the caudal pole of the left parotid gland without systemic symptoms. Histologically, the tumor consisted of a spindle cell proliferation in an intraparotideal lymph node. Based on the histopathologic, immunohistochemical and electron microscopic findings, a dendritic cell tumor, not otherwise specified (NOS) in an intraparotideal lymph node was diagnosed. The patient underwent complete tumor resection, and is currently free of disease, 2 years after surgery. These extremely rare tumors must be distinguished from other more common tumors in the salivary glands. Awareness that dendritic cell tumors may occur in this localization, careful histologic evaluation and ancillary immunohistochemical and electron microscopical analyses should allow for recognition of this entity.
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Affiliation(s)
- Sebastian P Schraven
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Germany.
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