Zaya Alejandro Martin, González Ana Carolina, Sandrone Silvana S, Sambuelli Ruben Horacio
Servicio de Anatomía Patológica Hospital Rawson. Cátedra de Anatomía Patológica y Fisiopatología, Facultad de Medicina, Universidad Católica de Córdoba.
Biología Celular, Histología y Embriología, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba.
Rev Fac Cien Med Univ Nac Cordoba. 2016;73(2):126-31.
follicular dendritic cell sarcoma (FDC sarcoma) is an uncommon neoplasm derived from FDC present in lymphoid follicles. It usually presents in lymph nodes, being extranodal location a very unusual event.
A 78 year old female, with prior left nephrectomy for invasive urothelial carcinoma, consulted for genitorragia. At examination, a polypoid vaginal lesion, measuring 3.5 cm in diameter was discovered. It was reported as squamous cell carcinoma in incisional biopsy. A polipectomy was performed. Examination of resected specimen showed a tumor having pushing edges, arranged in a solid pattern with spindle and epithelioid cells, having a syncytial appearance, diffusely sprinkled with numerous lymphocytes and granulocytes. At immunohistochemistry neoplastic cells were positive for vimentin, CD 68, CD 21 and fascine, and focally positive for S-100 and CD45. Occasional scattered neoplastic cells expressed CD30 and CD 23. They were negative for CD3, CD20, myeloperoxidase, AE1 / AE3, EMA, HMB45, Melan A, desmin, Chromogranin, CD1a and CD35. Infiltrating lymphocites were mainly of T cell lineage (CD3 +).
We report a case of FDC sarcoma in an unusual location, being to our knowledge, the first one at this site. The fact of having a prior neoplasia posed additional difficulties in differential diagnosis. Histological findings with expression of a specific marker of FDC (in this case CD21) allowed us to establish an accurate diagnosis.
滤泡树突状细胞肉瘤（FDC肉瘤）是一种源自淋巴滤泡中FDC的罕见肿瘤。它通常出现在淋巴结中，结外部位则非常罕见。
一名78岁女性，既往因浸润性尿路上皮癌接受左肾切除术，因生殖器出血前来就诊。检查时发现一个直径3.5厘米的息肉样阴道病变。切开活检报告为鳞状细胞癌。进行了息肉切除术。切除标本检查显示肿瘤边界呈推挤状，由梭形细胞和上皮样细胞呈实性排列，具有合体细胞外观，弥漫性散在大量淋巴细胞和粒细胞。免疫组化显示肿瘤细胞波形蛋白、CD68、CD21和肌动蛋白呈阳性，S-100和CD45局灶性阳性。偶尔散在的肿瘤细胞表达CD30和CD23。它们CD3、CD20、髓过氧化物酶、AE1 / AE3、EMA、HMB45、Melan A（黑素A）、结蛋白、嗜铬粒蛋白、CD1a和CD35呈阴性。浸润淋巴细胞主要为T细胞谱系（CD3 +）。
我们报告了一例罕见部位的FDC肉瘤病例，据我们所知，这是该部位的首例。既往有肿瘤病史给鉴别诊断带来了额外困难。FDC特异性标志物（本例为CD21）表达的组织学表现使我们能够做出准确诊断。
