Department of Pathology, New York University Langone Health, New York, NY, USA.
Cytopathology. 2022 Jan;33(1):119-122. doi: 10.1111/cyt.13047. Epub 2021 Aug 30.
Follicular dendritic cell sarcomas (FDCS) are rare tumours of lymph nodes and extranodal tissues which are grouped with the histiocytic and dendritic cell neoplasms. The diagnosis is usually made after thorough clinical and pathological examination with immunohistochemical analysis. Difficulties persist in diagnosing FDCS on cytological preparations. We report herein a case of a 57-year-old female who presented with a right neck mass of 5 months duration. Computed Tomography (CT) imaging of the neck reported a necrotic right level IIb lymph node and asymmetric fullness of the right palatine tonsil. Fine needle aspiration (FNA) biopsy revealed numerous spindle, oval and stellate neoplastic cells, arranged singly and in syncytia with moderate nuclear pleomorphism, vesicular chromatin pattern, and prominent nucleoli, sprinkled with small lymphocytes. The tumour cells were strongly diffusely positive for CD21, CD23, and D2-40 immunostaining on cell bock sections, but were negative for CD1a and CD34, supporting the diagnosis of FDCS. Follow-up surgical pathology on the resection showed histopathological features and an immunohistochemical profile consistent with FDCS.
滤泡树突细胞肉瘤（FDCS）是一种罕见的淋巴结和结外组织肿瘤，与组织细胞和树突状细胞肿瘤归为一类。诊断通常需要通过彻底的临床和病理检查以及免疫组织化学分析来完成。在细胞学标本中诊断 FDCS 仍然存在困难。我们在此报告一例 57 岁女性患者，其右侧颈部肿块持续了 5 个月。颈部计算机断层扫描（CT）报告显示右侧 IIb 水平坏死性淋巴结和右侧扁桃体不对称性饱满。细针抽吸（FNA）活检显示大量梭形、椭圆形和星状的肿瘤细胞，呈单个或合胞体排列，具有中度核异型性、泡状染色质模式和明显的核仁，散布着小淋巴细胞。肿瘤细胞在细胞块切片上强烈弥漫性表达 CD21、CD23 和 D2-40 免疫染色，但 CD1a 和 CD34 阴性，支持 FDCS 的诊断。切除后的随访手术病理显示与 FDCS 一致的组织病理学特征和免疫组织化学特征。
