Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Rd E, Guangzhou 510060, China.
Department of Integrated Therapy in Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
AJR Am J Roentgenol. 2021 Mar;216(3):835-843. doi: 10.2214/AJR.19.22759. Epub 2021 Jan 6.
The objective of this study was to assess the imaging features of follicular dendritic cell sarcoma (FDCS) on CT and MRI. The clinical data and pretreatment findings of 20 patients with pathologically proven FDCS on CT ( = 15), MRI ( = 7), or both ( = 2) were analyzed retrospectively. Tumor location, number, size, morphology, attenuation or signal intensity, margin, presence of metastases, and contrast enhancement were evaluated. FDCS originated from lymph nodes ( = 6) or a variety of extranodal sites ( = 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 ( = 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 ( = 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 ( = 4) and distant metastases ( = 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. 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.
本研究旨在评估滤泡树突状细胞肉瘤（FDCS）的 CT 和 MRI 影像学特征。回顾性分析了 20 例经病理证实的 FDCS 患者的临床资料和术前 CT（=15 例）、MRI（=7 例）或两者（=2 例）的影像学表现。评估了肿瘤的位置、数量、大小、形态、衰减或信号强度、边缘、转移灶和对比增强情况。FDCS 起源于淋巴结（=6 例）或多种结外部位（=14 例）。肿瘤通常为单发、边界清楚。结外病变（主要位于腹部或纵隔，平均直径为 11.8cm）大于淋巴结病变（平均直径为 6.5cm）。淋巴结型病例在 CT 和 MRI 上表现为均匀肿块。然而，在 CT 上，所有的结外肿瘤（=12 例）均表现出不均匀的衰减，其中 91.7%（11/12）因内部坏死而存在较低衰减区，50.0%（6/12）显示钙化。在 MRI 上，原发性肝或脾肿瘤（=3 例）也表现为大的不均匀肿块。7 例（35.0%）患者为晚期疾病，腹部结外病例更可能出现区域性淋巴结病（=4 例）和远处转移（=5 例）。90.0%（18/20）的患者表现为富血管性，14 例肿瘤中有 11 例（78.6%）在多期成像中表现为渐进性增强。FDCS 是一种罕见的、主要为单发的、边界清楚的恶性肿瘤。淋巴结型 FDCS 通常表现为小的均匀肿块，而纵隔或腹部的结外 FDCS 表现为大的不均匀肿块，伴有内部坏死和钙化，并伴有区域性淋巴结病。大多数肿瘤表现为富血管性和渐进性增强。
