Yang Grace C H, Wang Jun, Yee Herman T
Department of Pathology, New York University School of Medicine, New York, New York, USA.
Acta Cytol. 2006 Sep-Oct;50(5):534-8. doi: 10.1159/000326009.
Follicular dendritic cell (FDC) tumor is a rare tumor derived from accessory cells in the lymphoid follicles. FDC tumors are typically diagnosed on histology based on immunoreactivity to at least 1 of the FDC markers (CD21, CD23 or CD35) or based on the characteristic ultrastructural feature of long, interwoven, cytoplasmic, dendritic processes connected by desmosomes.
We observed novel cytologic features of FDC sarcoma in a liver fine needle aspirate of a 46-year-old man status post surgery and chemotherapy for FDC sarcoma, originating in the gastrointestinal tract with metastases to the liver, pancreas and spleen. In the Diff-Quik- and Papanicolaou-stained smears, the tumor cells presented in syncytial fragments as well as single cells, as previously reported in the cytologic literature. However, the single cells were interconnected to neighboring single cells via long, thin, threadlike cytoplasmic processes in ultrafast Papanicolaou (UFP)-stained smears. The tumor cells possessed multipolar cytoplasmic processes rather than unipolar ones, as previously reported.
The ultrastructural features of a web of interwoven, dendritic, cytoplasmic processes of FDC tumor was demonstrated for the first time on cytology. Observation of this feature may allow the diagnosis to be made on cytology prior to histology, immunohistochemistry or electron microscopy.
滤泡树突状细胞（FDC）肿瘤是一种源自淋巴滤泡中辅助细胞的罕见肿瘤。FDC肿瘤通常在组织学上基于对至少一种FDC标志物（CD21、CD23或CD35）的免疫反应性进行诊断，或者基于由桥粒连接的长的、交织的、细胞质树突状突起的特征性超微结构特征进行诊断。
我们在一名46岁男性的肝脏细针穿刺抽吸物中观察到了FDC肉瘤的新细胞学特征，该男性因起源于胃肠道并转移至肝脏、胰腺和脾脏的FDC肉瘤接受了手术和化疗。在Diff-Quik染色和巴氏染色涂片中，肿瘤细胞以合胞体片段以及单个细胞的形式呈现，正如细胞学文献中先前报道的那样。然而，在超快速巴氏（UFP）染色涂片中，单个细胞通过长的、细的、丝状细胞质突起与相邻的单个细胞相互连接。肿瘤细胞具有多极细胞质突起，而非如先前报道的单极突起。
首次在细胞学上证实了FDC肿瘤的交织的、树突状细胞质突起网络的超微结构特征。观察到这一特征可能使在组织学、免疫组织化学或电子显微镜检查之前就能在细胞学上做出诊断。
