Department of Medical Imaging, Peking University Shougang Hospital, Beijing 100144, China.
Curr Med Imaging. 2024;20:1-6. doi: 10.2174/0115734056273583231210055038.
Follicular Dendritic Cell Sarcomas (FDCS)was first found in 1986; the specificity of the disease is its rarity, with an incidence of only 0.4%, numerous doctors for its lack of understanding, the accuracy of imaging diagnosis is not great, which is easy to delay the treatment. This article summarizes several characteristic imaging manifestations of FDCS to provide imaging physicians with an understanding of the imaging properties of this rare disease. When faced with complex cases, the radiologist can consider this disease and include it in the differential diagnosis. FDCS occurs mainly in lymph nodes, mainly in the head and neck. The main symptoms are fatigue, local pain, or painless mass. The treatment method is not uniform, but scholars agree that we should strive for the opportunity of surgery as much as possible.
This paper reported a case of FDCS with pelvic recurrence 3 years after surgery. The patient was suspected to have lymphoma by postoperative pathology in the local hospital, and it is recommended that the patient be reexamined regularly. A soft tissue mass was recently found again in the left pelvic cavity. After an enhanced CT examination, the radiologist was skeptical of the previous diagnosis of lymphoma. Subsequently, a needle biopsy was performed at Peking University Shougang Hospital. The pathological results rejected the prior diagnosis of lymphoma after consultation with additional hospitals, and the patient was diagnosed with FDCS.
The imaging manifestations of FDCS lack absolute specificity, but it also has imaging characteristics, such as large areas of necrosis in the huge mass, rough mass calcification in the mass, enhanced scan showed "fast in and slow out" mode, and there were blood vessels in the tumor. FDCS mainly occurs in lymph nodes and is easily misdiagnosed as GIST, inflammatory myoblastoma, lymphoma, etc. Radiologists should continue to collect cases of this disease and include suspected cases in the differential diagnosis in clinical work.
滤泡树突细胞肉瘤（FDCS）于 1986 年首次发现；该病的特异性在于其罕见性，发病率仅为 0.4%，许多医生对其缺乏了解，影像学诊断的准确性不高，容易延误治疗。本文总结了 FDCS 的几种特征性影像学表现，为影像医师了解这种罕见疾病的影像学特征提供帮助。当面对复杂病例时，放射科医生可以考虑这种疾病，并将其纳入鉴别诊断。FDCS 主要发生于淋巴结，主要发生于头颈部。主要症状为乏力、局部疼痛或无痛性肿块。治疗方法不统一，但学者们一致认为应尽可能争取手术机会。
本文报道了 1 例 FDCS 术后 3 年盆腔复发的病例。患者在当地医院术后病理疑为淋巴瘤，建议定期复查。近期再次发现左盆腔软组织肿块。行增强 CT 检查后，放射科医生对之前淋巴瘤的诊断持怀疑态度。随后在北京大学首钢医院行针吸活检。病理会诊结果排除了淋巴瘤的前期诊断，患者被诊断为 FDCS。
FDCS 的影像学表现缺乏绝对特异性，但也有一定的影像学特征，如巨大肿块内大片状坏死、肿块内粗糙钙化、增强扫描呈“快进慢出”模式、肿瘤内有血管。FDCS 主要发生于淋巴结，易误诊为 GIST、炎性肌纤维母细胞瘤、淋巴瘤等。放射科医生应继续收集该病病例，并在临床工作中纳入疑似病例进行鉴别诊断。
