1. Nodal follicular dendritic cell sarcoma with four atypical histomorphologic features: an unusual case report
- Author
-
Yu Zhang, Guangjie Duan, Feng Wu, Xiao-Chu Yan, You-Li Wu, and Robinson Ateh Mbako
- Subjects
Male ,0301 basic medicine ,Pathology ,medicine.medical_specialty ,Histology ,Biopsy ,Lymph node biopsy ,Case Report ,Dendritic Cell Sarcoma, Follicular ,Malignancy ,Pathology and Forensic Medicine ,Metastatic carcinoma ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,hemic and lymphatic diseases ,Diagnosis ,lcsh:Pathology ,Biomarkers, Tumor ,medicine ,Carcinoma ,Humans ,Diagnostic Errors ,Anaplastic large-cell lymphoma ,Hemangiopericytoma ,medicine.diagnostic_test ,business.industry ,Variants ,General Medicine ,Middle Aged ,medicine.disease ,Hodgkin Disease ,Lymphoma ,030104 developmental biology ,030220 oncology & carcinogenesis ,Follicular dendritic cell sarcoma ,Histomorphology ,business ,lcsh:RB1-214 - Abstract
Background Follicular dendritic cell sarcoma (FDCS) is a rare malignancy. In addition to the classical histopathologic features, it has also some special morphological variants that can present a challenge in the diagnosis of this disease. Case presentation A 45-year-old male who presented with a left supraclavicular mass was given a final diagnosis of FDCS after lymph node biopsy. The specimen obtained during radical resection revealed five different morphologies, including the classical histological appearance and atypical areas resembling desmoplastic infiltrative carcinoma, anaplastic large cell lymphoma (ALCL), hemangiopericytoma and classical Hodgkin’s lymphoma (CHL). Immunohistochemistry was notable for positive CD21 and CD23 expression across all morphologies. Given the atypical appearance and location, the specimen was initially misdiagnosed as a metastatic carcinoma based on histology alone at an outside institution. The patient eventually underwent surgical resection followed by adjuvant chemotherapy and radiation. Despite treatment, the disease progressed, and the patient passed away 36 months after surgery. Conclusions This unusual case of FDCS contains four types of atypical histomorphologies within a single tumor specimen, including those resembling ALCL and hemangiopericytoma which are described here for the first time. Our report further expands the histopathologic spectrum of FDCS and may help assist in the diagnosis of other such challenging cases.
- Published
- 2019