Zhang Shu-hong, Zhou Xiao-ge, Zheng Yuan-yuan, Zhang Yan-ning, Wang Peng, Xie Jian-lan, Jin Yan, Zheng Xiao-dan
Department of Pathology, Beijing Friendship Hospital, Capital University of Medical Sciences, China.
Zhonghua Zhong Liu Za Zhi. 2010 Feb;32(2):123-7.
To investigate the clinicopathologic features and differential diagnostic methods for follicular dendritic cell sarcoma.
Histological and immunohistochemical examinations and EBER in situ hybridization were used to investigate the pathological features of 5 cases of follicular dendritic cell sarcoma, and related literature was reviewed.
There were 3 males and 2 females with a median age of 54 years (range, 28 - 75 years). The location of lesions included lymph node (2 cases), tonsil (1 case), stomach (1 case), and liver (1 case). The growth patterns were fascicular or whorls and/or diffuse. The neoplastic cells were spindle or ovoid in shape with indistinct border and slightly eosinophilic cytoplasm. The nuclei were round, oval or spindle in shape with small distinct nucleoli. Warthin-Finkeldey-like multinucleated giant cells were detected in two cases. Mitotic figures were found in 1-22/10 HPF. Immunohistochemical staining showed that CD21 and CD23 (3 of 5), CD35 (4 of 5), D2-40 (4 of 4), and CXCL13 (3 of 4) were positive in neoplastic cells. EBER was detected in one of five cases by in situ hybridization. Four cases were followed-up for 6 approximately 25 months and no recurrence or death was observed yet.
Follicular dendritic cell sarcoma is an extremely rare and should be considered as a moderately malignant tumor, and may present histological polymorphism with certain distinctive features. Immunohistochemistry is necessary in differential diagnosis to distinguish from other tumors.
探讨滤泡树突状细胞肉瘤的临床病理特征及鉴别诊断方法。
采用组织学、免疫组化检查及EBER原位杂交技术，对5例滤泡树突状细胞肉瘤的病理特征进行研究，并复习相关文献。
5例患者中男性3例，女性2例，中位年龄54岁（范围28 - 75岁）。病变部位包括淋巴结（2例）、扁桃体（1例）、胃（1例）和肝（1例）。生长方式为束状或漩涡状和/或弥漫性。肿瘤细胞呈梭形或卵圆形，边界不清，胞质轻度嗜酸性。细胞核呈圆形、椭圆形或梭形，核仁小而明显。2例检测到Warthin-Finkeldey样多核巨细胞。每10个高倍视野中可见1 - 22个核分裂象。免疫组化染色显示肿瘤细胞中CD21和CD23（5例中的3例）、CD35（5例中的4例）、D2-40（4例中的4例）及CXCL13（4例中的3例）呈阳性。原位杂交检测5例中有1例EBER阳性。4例随访6至25个月，未见复发或死亡。
滤泡树突状细胞肉瘤极为罕见，应被视为中度恶性肿瘤，可能呈现具有某些独特特征的组织学多态性。免疫组化在鉴别诊断中是必要的，以与其他肿瘤相区分。
