Selvan V Saravana, Raj P Karthik, Vivek M, Siddique S Mohamed, Kumar N Suresh
Upgraded Institute of Otorhinolaryngology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, 600003 India.
Indian J Otolaryngol Head Neck Surg. 2025 May;77(5):2200-2205. doi: 10.1007/s12070-025-05483-8. Epub 2025 Apr 23.
Follicular dendritic cells (FDC) are mesenchymal-derived dendritic cells in B-cell follicles. They play a crucial role in initiating and maintaining the adaptive immune response of B-cells. In 1986, Dr. Juan Rosai first reported a series of neoplasms showing features of FDC and defined it as a Follicular Dendritic Cell Tumor, subsequently renamed as "sarcoma" (FDCS). The diagnosis of FDCS is based on a combination of clinical examination, histopathologic features, electron microscopy, and confirmation through immunohistochemical studies. Here, we report a case of a 55-year-old female who presented to our OPD with complaints of recurrent throat pain and difficulty during swallowing for the past 2 years, along with a foreign body sensation in the throat with occasional minimal bleeding from the left tonsillar region. Left ECA ligation with left tonsillectomy by cauterization method was done under GA. The Histopathological report came to be Follicular Dendritic Cell Sarcoma of the tonsil after IHC confirmation. After the diagnosis, the patient received post-operative radiotherapy. The patient is on a six-month follow-up, which is uneventful. FDCS is a rare tumor, particularly in extranodal sites. The diagnosis must be kept in mind when confronted with uncommon histological features in lymphoid tissue, and the final diagnosis can be rendered only after proper immunohistochemical examination.
滤泡树突状细胞(FDC)是B细胞滤泡中源自间充质的树突状细胞。它们在启动和维持B细胞的适应性免疫反应中起着至关重要的作用。1986年,胡安·罗赛博士首次报告了一系列具有FDC特征的肿瘤,并将其定义为滤泡树突状细胞瘤,随后更名为“肉瘤”(FDCS)。FDCS的诊断基于临床检查、组织病理学特征、电子显微镜检查以及免疫组织化学研究的确认。在此,我们报告一例55岁女性病例,该患者因过去2年反复出现咽痛、吞咽困难,伴有咽部异物感且左侧扁桃体区域偶尔有少量出血,前来我们的门诊就诊。在全身麻醉下通过烧灼法进行了左侧颈外动脉结扎及左侧扁桃体切除术。免疫组织化学确认后,组织病理学报告显示为扁桃体滤泡树突状细胞肉瘤。诊断后,患者接受了术后放疗。患者正在进行为期六个月的随访,目前情况平稳。FDCS是一种罕见肿瘤,尤其是在结外部位。当面对淋巴组织中不常见的组织学特征时,必须考虑到这种诊断,只有经过适当的免疫组织化学检查才能做出最终诊断。