Abe K, Kitago M, Matsuda S, Shinoda M, Yagi H, Abe Y, Oshima G, Hori S, Endo Y, Yokose T, Miura E, Kubota N, Ueno A, Masugi Y, Ojima H, Sakamoto M, Kitagawa Y
Department of Surgery, Keio University School of Medicine, Shinanomachi 35, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Department of Pathology, Keio University School of Medicine, Tokyo, Japan.
Surg Case Rep. 2022 Dec 9;8(1):220. doi: 10.1186/s40792-022-01572-w.
BACKGROUND: Follicular dendritic cell sarcoma is a rare stromal tumor with no standard treatment. However, some reports have revealed that follicular dendritic cell sarcoma has an inflammatory pseudotumor variant associated with Epstein-Barr virus infection that has a relatively good prognosis. In this report, we present a case of a resected inflammatory pseudotumor variant of follicular dendritic cell sarcoma of the liver, and have reviewed the literature on the clinicopathological, molecular, and genomic features of this tumor. CASE PRESENTATION: The inflammatory pseudotumor variant of follicular dendritic cell sarcoma originates only in the liver or spleen, causes no symptoms, and is more common in middle-aged Asian women. It has no characteristic imaging features, which partially explains why the inflammatory pseudotumor variant of follicular dendritic cell sarcoma is difficult to diagnose. Pathologically, the inflammatory pseudotumor variant of follicular dendritic cell sarcoma has spindle cells mixed with inflammatory cells and is variably positive for follicular dendritic cell markers (CD21, CD23, and CD35) and Epstein-Barr virus-encoded RNA. On genetic analysis, patients with this tumor high levels of latent membrane protein 1 gene expression and extremely low levels of host C-X-C Chemokine Receptor type 7 gene expression, indicating that the inflammatory pseudotumor variant of follicular dendritic cell sarcoma has a latent Epstein-Barr virus type 2 infection. CONCLUSIONS: The inflammatory pseudotumor variant of follicular dendritic cell sarcoma is an Epstein-Barr virus-associated tumor and a favorable prognosis by surgical resection, similar to Epstein-Barr virus-associated gastric cancer.
背景:滤泡树突状细胞肉瘤是一种罕见的间质肿瘤,尚无标准治疗方法。然而,一些报告显示,滤泡树突状细胞肉瘤有一种与爱泼斯坦-巴尔病毒感染相关的炎性假瘤变体,其预后相对较好。在本报告中,我们展示了一例经手术切除的肝脏滤泡树突状细胞肉瘤炎性假瘤变体病例,并回顾了有关该肿瘤临床病理、分子和基因组特征的文献。 病例介绍:滤泡树突状细胞肉瘤炎性假瘤变体仅起源于肝脏或脾脏,无任何症状,在亚洲中年女性中更为常见。它没有特征性的影像学表现,这部分解释了滤泡树突状细胞肉瘤炎性假瘤变体难以诊断的原因。病理上,滤泡树突状细胞肉瘤炎性假瘤变体有梭形细胞与炎性细胞混合,滤泡树突状细胞标志物(CD21、CD23和CD35)及爱泼斯坦-巴尔病毒编码RNA呈不同程度阳性。基因分析显示,该肿瘤患者潜伏膜蛋白1基因表达水平高,宿主C-X-C趋化因子受体7型基因表达水平极低,表明滤泡树突状细胞肉瘤炎性假瘤变体存在2型潜伏性爱泼斯坦-巴尔病毒感染。 结论:滤泡树突状细胞肉瘤炎性假瘤变体是一种与爱泼斯坦-巴尔病毒相关的肿瘤,手术切除后预后良好,类似于与爱泼斯坦-巴尔病毒相关的胃癌。
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