Jiménez-Heffernan José A, Díaz Del Arco Cristina, Adrados Magdalena
Department of Pathology, University Hospital La Princesa, Diego de León, 62, 28006 Madrid, Spain.
Department of Pathology, University Hospital Clínico San Carlos, Profesor Martín Lagos s/n, 28040 Madrid, Spain.
Diagnostics (Basel). 2022 Feb 4;12(2):406. doi: 10.3390/diagnostics12020406.
Follicular dendritic cells (FDCs) are antigen-presenting cells located in the germinal centers of the lymph nodes. Among the few tumors showing FDC differentiation are follicular dendritic cell sarcoma (FDCS) and Castleman disease (CD), more precisely the unicentric hyaline vascular (HV) variant. Both are relatively rare tumors, and the diagnostic cytological experience is limited to descriptions of isolated cases or small series. The purpose of this review is to bring together all the available cytological published information, and our personal experience, in order to obtain a global idea of the cytological features of these peculiar FDC-derived tumors. The different descriptions of FDCS are very similar, reflecting a tumor that shows repetitive and characteristic cytological features. It shows a dimorphic population of mature lymphocytes and large tumoral cells with partial spindle morphology. Most cases of HV variant of CD can be recognized as benign upon cytology, however a precise diagnosis seems more difficult. It is characterized by reactive lymphocytes mixed with vessels and FDCs, either single or forming syncytial aggregates. Both, FDCS and CD are challenging for cytological diagnosis in which a high index of suspicion is necessary for a correct preoperative assessment. Cytology is very useful for follow-up of recurrences and metastases.
滤泡树突状细胞（FDCs）是位于淋巴结生发中心的抗原呈递细胞。少数显示FDC分化的肿瘤包括滤泡树突状细胞肉瘤（FDCS）和Castleman病（CD），更确切地说是单中心透明血管（HV）型。这两种都是相对罕见的肿瘤，诊断细胞学经验仅限于对个别病例或小系列病例的描述。本综述的目的是汇集所有已发表的细胞学信息以及我们的个人经验，以便全面了解这些特殊的FDC来源肿瘤的细胞学特征。对FDCS的不同描述非常相似，反映出一种具有重复性和特征性细胞学特征的肿瘤。它表现为成熟淋巴细胞和具有部分梭形形态的大肿瘤细胞的双相群体。大多数HV型CD病例在细胞学上可被认为是良性的，然而精确诊断似乎更困难。其特征是反应性淋巴细胞与血管和FDCs混合，单个或形成合体聚集物。FDCS和CD在细胞学诊断方面都具有挑战性，正确的术前评估需要高度的怀疑指数。细胞学对于复发和转移的随访非常有用。
