Department of Gastroenterology, Digestive Disease Hospital, The Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, People's Republic of China.
Department of General Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, People's Republic of China.
World J Surg Oncol. 2023 Jul 21;21(1):212. doi: 10.1186/s12957-023-03115-5.
Pancreatic follicular dendritic cell sarcoma (FDCS) is an exceptionally rare and low-to-moderate malignancy, with only seven reported cases to date. Clinical diagnosis of FDCS is challenging due to the lack of distinct biological and radiographic features.
A 67-year-old woman presented to the hospital with a 4-day history of severe abdominal pain. Imaging studies (CT and MRI) revealed a large cystic mass located at the tail of the pancreas, which was suspected to be myeloid sarcoma (MS) based on EUS and CT-guided pancreatic puncture. Postoperative pathology and immunohistochemistry confirmed the diagnosis of pancreatic FDCS. After the diagnosis was confirmed, the patient received postoperative chemotherapy with the CHOP regimen. At 11 months of follow-up, there was no evidence of recurrence. Seven published cases have been reviewed to comprehensively summarize the clinical characteristics, diagnosis, and treatment options of FDCS.
While imaging can be useful in detecting pancreatic FDCS, it should be interpreted with caution as it can be challenging to differentiate from other pancreatic tumors. Pathology and immunohistochemistry are considered the gold standard for diagnosis, with CD21, CD23, and CD35 being specific tumor cell markers. However, preoperative diagnosis of pancreatic FDCS remains difficult, and the pancreatic puncture may further increase the risk of misdiagnosis. The disease is highly prone to recurrence and metastasis, and surgery is the preferred method for both diagnosis and treatment of localized disease.
胰腺滤泡树突状细胞肉瘤（FDCS）是一种非常罕见的低度至中度恶性肿瘤，迄今为止仅报告了 7 例。由于缺乏独特的生物学和影像学特征，FDCS 的临床诊断具有挑战性。
一名 67 岁女性因腹痛 4 天就诊。影像学检查（CT 和 MRI）显示胰腺尾部有一个大的囊性肿块，根据 EUS 和 CT 引导下的胰腺穿刺，怀疑为髓样肉瘤（MS）。术后病理和免疫组化证实了胰腺 FDCS 的诊断。确诊后，患者接受了 CHOP 方案的术后化疗。随访 11 个月，未见复发。我们回顾了 7 篇已发表的病例报告，全面总结了 FDCS 的临床特征、诊断和治疗选择。
尽管影像学检查有助于检测胰腺 FDCS，但应谨慎解读，因为其与其他胰腺肿瘤的鉴别具有一定难度。病理和免疫组化被认为是诊断的金标准，CD21、CD23 和 CD35 是特异性肿瘤细胞标志物。然而，胰腺 FDCS 的术前诊断仍然困难，胰腺穿刺可能会进一步增加误诊的风险。该疾病极易复发和转移，手术是诊断和治疗局限性疾病的首选方法。
