Moriki T, Takahashi T, Wada M, Ueda S, Ichien M, Yamane T, Hara H
Department of Clinical Laboratory Medicine, Kochi Medical School Hospital, Japan.
Pathol Res Pract. 1997;193(9):629-39; discussion 640-2. doi: 10.1016/S0344-0338(97)80041-6.
Follicular dendritic cell (FDC) tumor is an exceedingly rare malignant neoplasm and occurs mainly in the cervical lymph nodes. We report a mesenteric FDC tumor occurring in a 66-year-old female, that manifested with intraabdominal multifocal recurrence 7 years after resection of the primary tumor. Histologically, both primary and recurrent tumors were composed of oval to spindle cells with paley eosinophilic cytoplasms, indistinct cell borders, round to elongated nuclei with clear or finely dispersed chromatin, and medium to large nucleoli. Characteristically, the tumor cells were growing in sheets, fascicles, and sometimes in whorls and a storiform pattern. In addition, focal necrosis, nuclear pleomorphism and abnormal mitoses were also observed. The neoplastic cells were intimately admixed with small lymphocytes. The diagnosis was confirmed by positive immunoreactivity with CD21 and CD35 antibodies and by ultrastructural demonstration of convoluted interdigitating cell processes connected by scattered desmosome-like junctions. Although our case showed a low proliferative activity evaluated by MIB-1, multifocal recurrence has occurred. The clinicopathologic features and differential diagnosis of FDC tumors are discussed with the review of the literature.
滤泡树突状细胞（FDC）肿瘤是一种极其罕见的恶性肿瘤，主要发生于颈部淋巴结。我们报告一例发生在66岁女性的肠系膜FDC肿瘤，该肿瘤在原发肿瘤切除7年后出现腹腔内多灶性复发。组织学上，原发肿瘤和复发肿瘤均由椭圆形至梭形细胞组成，细胞质淡嗜酸性，细胞边界不清，核圆形至细长形，染色质清晰或呈细颗粒状分布，核仁中等至大。其特征性表现为肿瘤细胞呈片状、束状生长，有时呈漩涡状和车辐状排列。此外，还观察到局灶性坏死、核多形性和异常核分裂。肿瘤细胞与小淋巴细胞紧密混合。通过CD21和CD35抗体免疫反应阳性以及超微结构显示由散在的桥粒样连接相连的迂曲指状细胞突起而确诊。尽管我们的病例通过MIB-1评估显示增殖活性较低，但仍发生了多灶性复发。本文结合文献复习讨论了FDC肿瘤的临床病理特征及鉴别诊断。
