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Lorenzi L, Haferlach T, Mori L, Simbeni M, Walter W, Balzarini P, Meggendorfer M, Döring C, Lonardi S, Bugatti M, Agostinelli C, Mehta J, Borges A, Agaimy A, Simonitsch-Klupp I, Cabeçadas J, Campo E, Pileri SA, Facchetti F, Leo Hansmann M, Hartmann S. Massive parallel sequencing unveils homologous recombination deficiency in follicular dendritic cell sarcoma. Haematologica 2024; 109:1815-1824. [PMID: 37994105 PMCID: PMC11141687 DOI: 10.3324/haematol.2023.283669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023] Open
Abstract
Standardized treatment options are lacking for patients with unresectable or multifocal follicular dendritic cell sarcoma (FDCS) and disease-related mortality is as high as 20%. Applying whole-genome sequencing (WGS) in one case and whole-exome sequencing (WES) in additional twelve cases, this study adds information on the molecular landscape of FDCS, expanding knowledge on pathobiological mechanisms and identifying novel markers of potential theragnostic significance. Massive parallel sequencing showed high frequency of mutations on oncosuppressor genes, particularly in RB1, CARS and BRCA2 and unveiled alterations on homologous recombination DNA damage repair-related genes in 70% (9/13) of cases. This indicates that patients with high-stage FDCS may be eligible for poly ADP ribose polymerase inhibition protocols. Low tumor mutational burden was confirmed in this study despite common PDL1 expression in FDCS arguing on the efficacy of immune checkpoint inhibitors. CDKN2A deletion, detected by WGS and confirmed by fluorescence in situ hybridization in 41% of cases (9/22) indicates that impairment of cell cycle regulation may sustain oncogenesis in FDCS. Absence of mutations in the RAS/RAF/MAPK pathway and lack of clonal hematopoiesis-related mutations in FDCS sanction its differences from dendritic cell-derived neoplasms of hematopoietic derivation. WGS and WES in FDCS provides additional information on the molecular landscape of this rare tumor, proposing novel candidate genes for innovative therapeutical approaches to improve survival of patients with multifocal disease.
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Affiliation(s)
- Luisa Lorenzi
- Pathology Unit, ASST Spedali Civili di Brescia, Department of Molecular and Translational Medicine, University of Brescia, Brescia.
| | | | - Luigi Mori
- Laboratory of Molecular Medicine, Department of Clinical and Experimental Science, University of Brescia, Brescia
| | - Matteo Simbeni
- Pathology Unit, ASST Spedali Civili di Brescia, Department of Molecular and Translational Medicine, University of Brescia, Brescia
| | | | - Piera Balzarini
- Pathology Unit, ASST Spedali Civili di Brescia, Department of Molecular and Translational Medicine, University of Brescia, Brescia
| | | | - Claudia Döring
- Dr Senckenberg Institute of Pathology, Goethe University, Frankfurt
| | - Silvia Lonardi
- Pathology Unit, ASST Spedali Civili di Brescia, Department of Molecular and Translational Medicine, University of Brescia, Brescia
| | - Mattia Bugatti
- Pathology Unit, ASST Spedali Civili di Brescia, Department of Molecular and Translational Medicine, University of Brescia, Brescia
| | - Claudio Agostinelli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy"
| | | | | | - Abbas Agaimy
- Institute of Pathology, University Hospital, Erlangen
| | | | - José Cabeçadas
- Department of Pathology, Portuguese Institute of Oncology, Lisbon, Portugal
| | - Elias Campo
- Hematopathology Section, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Stefano Aldo Pileri
- Division of Haematopathology, European Institute of Oncology (IEO) IRCCS, Milan
| | - Fabio Facchetti
- Pathology Unit, ASST Spedali Civili di Brescia, Department of Molecular and Translational Medicine, University of Brescia, Brescia
| | - Martin Leo Hansmann
- Institute for General Pharmacology and Toxicology, Goethe University, Frankfurt
| | - Sylvia Hartmann
- Dr Senckenberg Institute of Pathology, Goethe University, Frankfurt
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2
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Sohrabi S, Masoumi J, Naseri B, Ghorbaninezhad F, Alipour S, Kazemi T, Ahmadian Heris J, Aghebati Maleki L, Basirjafar P, Zandvakili R, Doustvandi MA, Baradaran B. STATs signaling pathways in dendritic cells: As potential therapeutic targets? Int Rev Immunol 2024; 43:138-159. [PMID: 37886903 DOI: 10.1080/08830185.2023.2274576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023]
Abstract
Dendritic cells (DCs) are professional antigen-presenting cells (APCs), including heterogenous populations with phenotypic and functional diversity that coordinate bridging innate and adaptive immunity. Signal transducer and activator of transcriptions (STAT) factors as key proteins in cytokine signaling were shown to play distinct roles in the maturation and antigen presentation of DCs and play a pivotal role in modulating immune responses mediated by DCs such as differentiation of T cells to T helper (Th) 1, Th2 or regulatory T (Treg) cells. This review sheds light on the importance of STAT transcription factors' signaling pathways in different subtypes of DCs and highlights their targeting potential usages for improving DC-based immunotherapies for patients who suffer from cancer or diverse autoimmune conditions according to the type of the STAT transcription factor and its specific activating or inhibitory agent.
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Affiliation(s)
- Sepideh Sohrabi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javad Masoumi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahar Naseri
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Shiva Alipour
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tohid Kazemi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Pedram Basirjafar
- Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Raziyeh Zandvakili
- Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Yan J, Zhang X, Yu L, Ye M, Chen Y. Long-Term Follow-Up of Combination Therapy with Sintilimab and Anlotinib in Gallbladder Follicular Dendritic Cell Sarcoma: A Rare Case Report. Onco Targets Ther 2024; 17:287-295. [PMID: 38586813 PMCID: PMC10999206 DOI: 10.2147/ott.s449258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/22/2024] [Indexed: 04/09/2024] Open
Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare malignant neoplasm for which a standardized treatment approach has yet to be established. The prevailing therapeutic strategy typically involves resection followed by adjuvant chemotherapy or radiation. This case report details the long-term follow-up of a 59-year-old Chinese male diagnosed with gallbladder FDCS and liver metastases. The patient received a combination therapy of sintilimab and anlotinib, resulting in a substantial partial response (PR) lasting for a noteworthy duration of 30 months. Notably, this is the first documented instance of gallbladder FDCS with liver metastases being treated with PD-1 antibody and antiangiogenic agents as first-line therapy. These findings suggest that this treatment regimen may offer a potential therapeutic option for patients with gallbladder FDCS and liver metastases, with a duration of PR lasting up to 30 months.
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Affiliation(s)
- Jieping Yan
- Clinical Pharmacy Center, Department of Pharmacy, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China
- Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, 310014, People’s Republic of China
| | - Xue Zhang
- Department of Pharmacy, Kunming Yan’an Hospital, Yan’an Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650051, People’s Republic of China
| | - Lili Yu
- Department of Pathology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China
| | - Meihua Ye
- Department of Pathology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China
| | - Yun Chen
- Cancer Center, Department of Oncology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China
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Assi T, Cesne AL. Immune checkpoint inhibitors in follicular dendritic cell sarcoma. Immunotherapy 2024; 16:341-344. [PMID: 38362643 DOI: 10.2217/imt-2023-0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Affiliation(s)
- Tarek Assi
- International Department, Gustave Roussy, 114, Rue Edouard Vaillant, Villejuif, France
| | - Axel Le Cesne
- International Department, Gustave Roussy, 114, Rue Edouard Vaillant, Villejuif, France
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5
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Zhang Y, Jin X, Lian L. Rare co-occurrence of tonsillar follicular dendritic cell sarcoma and schizophrenia: A comprehensive study. Clin Case Rep 2024; 12:e8700. [PMID: 38585586 PMCID: PMC10995268 DOI: 10.1002/ccr3.8700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 04/09/2024] Open
Abstract
This study investigated the infrequent occurrence of tonsillar follicular dendritic cell sarcoma (FDCS) co-existing with schizophrenia, presenting a comprehensive examination of clinical, pathological, and literature aspects. A systematic literature review was conducted, focusing on articles related to "schizophrenia" and "sarcoma," with in-depth analysis of included case reports. Clinical data, pathological findings, and patient follow-up information were collected and synthesized. The study detailed a rare case of FDCS in the tonsil concurrent with schizophrenia, providing insights into diagnosis, treatment, and follow-up. A literature review of combined FDCS in the tonsil and schizophrenia cases highlighted their clinical and pathological characteristics. Eight case reports encompassing 11 patients diagnosed with sarcoma and schizophrenia were included. Surgical resection was the preferred primary treatment, while chemotherapy was suggested for recurrences. Instances of co-occurring FDCS and schizophrenia were exceptionally limited, with tonsillar FDCS being particularly uncommon. The coexistence of tonsillar FDCS and schizophrenia was an exceptionally rare condition, posing diagnostic and therapeutic challenges. This study contributed valuable insights into clinical and pathological practice through a systematic review, underscoring the significance of early diagnosis and comprehensive management.
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Affiliation(s)
- Yu Zhang
- Department of Pathology, Hangzhou Hospital of Traditional Chinese MedicineZhejiang Chinese Medicine UniversityHangzhouP. R. China
| | - Xiaoxi Jin
- Department of PathologyWenzhou People's HospitalWenzhouP. R. China
| | - Liyan Lian
- Department of Pathologythe First Affiliated Hospital of Zhejiang UniversityHangzhouP. R. China
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Agüero R, Reculé F, Pérez J, Castro A. Extranodal Follicular Dendritic Cell Sarcoma Presenting on the Skin. Am J Dermatopathol 2024; 46:218-222. [PMID: 38457683 DOI: 10.1097/dad.0000000000002639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
ABSTRACT Follicular dendritic cell sarcoma is a rare intermediate-grade malignancy characterized by a proliferation of ovoid to spindle-shaped cells with morphologic and immunophenotypic features similar to normal follicular dendritic cells. It may develop in lymph nodes or extranodal sites. Its presentation in extranodal tissues is a diagnostic challenge. It requires a high index of suspicion because follicular dendritic cell markers are not included in the routine immunohistochemical panels used for differential diagnosis. In an extensive review of the English literature, we found 3 cases of follicular dendritic cell sarcoma developing on the skin. We report a case of a primary cutaneous follicular dendritic cell sarcoma in a 28-year-old man, which presented as a 6-mm skin-colored nodule on the right forearm. We describe the morphologic and immunohistochemical features and a review of the literature.
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Affiliation(s)
- Rosario Agüero
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Santiago, Chile
| | - Francisca Reculé
- Dermatology Service, Hospital Clínico de la Fuerza Aérea, Santiago, Chile
- Dermatology Service, Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Santiago, Chile ; and
| | - Jaime Pérez
- Dermatology Service, Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Santiago, Chile ; and
| | - Alex Castro
- Department of Pathology, Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Santiago, Chile
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Yamada T, Ishido K, Kimura N, Wakiya T, Nagase H, Goto S, Yoshizawa T, Kijima H, Kato S, Hakamada K. Follicular dendritic cell sarcoma arising from the lymph node of the pancreatic head: a case report with literature review. Clin J Gastroenterol 2024:10.1007/s12328-024-01956-5. [PMID: 38532076 DOI: 10.1007/s12328-024-01956-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024]
Abstract
A 72-year-old man was referred to our hospital for the examination of a pancreatic head mass. Abdominal computed tomography revealed a contrasted 8-cm-diameter tumor extending from the dorsal pancreatic head to the porta hepatis. The preoperative diagnosis was challenging due to the absence of specific imaging findings and the inability to perform a biopsy. Positron emission tomography/computed tomography and diffusion-weighted imaging suggested a malignant tumor originating from the organs surrounding the pancreatic head. Subtotal stomach-preserving pancreaticoduodenectomy with regional lymph node dissection was performed, as dissection from the pancreatic head proved unfeasible. Pathological examination identified the tumor as an enlarged lymph node consisting of pleomorphic large cells forming clusters, positive for follicular dendritic cell markers cluster of differentiation (CD) 21 and CD23. No evidence of tumor capsule infiltration, other organ infiltration, or metastasis to other lymph nodes was observed. The final diagnosis was nodal follicular dendritic cell sarcoma (FDCS) originating from the pancreatic head lymph nodes. No recurrence occurred at 3 years postoperatively with no postoperative treatment. Intraperitoneal nodal FDCS is extremely rare, and occasionally, it can lead to postoperative recurrence and progression. It is crucial to differentiate neoplastic lymph node enlargement around the pancreatic head from nodal FDCS.
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Affiliation(s)
- Takahiro Yamada
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8563, Japan.
| | - Keinosuke Ishido
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8563, Japan
| | - Norihisa Kimura
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8563, Japan
| | - Taiichi Wakiya
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8563, Japan
| | - Hayato Nagase
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8563, Japan
| | - Shintaro Goto
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8563, Japan
| | - Tadashi Yoshizawa
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8563, Japan
| | - Hiroshi Kijima
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8563, Japan
| | - Seiichi Kato
- Center for Clinical Pathology, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan
| | - Kenichi Hakamada
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8563, Japan
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Jha T, Sharma A, Kalakkunath S, Mullick S, Rahul E, Dixit M. Extranodal follicular dendritic cell sarcoma of the lung. Indian J Thorac Cardiovasc Surg 2024; 40:219-223. [PMID: 38389765 PMCID: PMC10879473 DOI: 10.1007/s12055-023-01599-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 02/24/2024] Open
Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare, mesenchymal neoplasm that may be nodal or extranodal in location. Lung involvement is rare. It is a slow-growing, painless tumor with a frequent capacity to recur and metastasize. We present a case of extranodal FDCS of the lung with an unusual presentation. A 34-year-old man presented with the complaints of haemoptysis and chest pain. A large left perihilar mass with endobronchial component was found on radiological evaluation. On endobronchial biopsy and mediastinal tru-cut biopsy, differential diagnoses of an inflammatory myo-fibrohistiocytic lesion and leiomyosarcoma were provided on the basis of morphological features of bipolar spindled cells arranged in intersecting fascicles and storiform patterns and immunophenotyping. A pneumonectomy was performed for the mass on which further immunohistochemical evaluation with CD21, CD35, and D2-40 finally helped form a diagnosis of FDCS. The patient recovered well from the surgery and has been on follow-up ever since. Owing to the rarity of this condition and its non-specific clinical features, FDCS is often misdiagnosed in the absence of appropriate immunohistochemistry. An of awareness of its morphological features and immunophenotype is, thus, necessary to provide early treatment and follow-up in order to prevent its recurrence and metastasis.
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Affiliation(s)
- Tanvi Jha
- Department of Pathology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, 110030 India
| | - Anil Sharma
- Department of Pathology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, 110030 India
| | - Sankar Kalakkunath
- Department of Pathology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, 110030 India
| | - Shalini Mullick
- Department of Pathology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, 110030 India
| | - Ekta Rahul
- Department of Pathology, All India Institute of Medical Sciences, Bilaspur, Chhattisgarh India
| | - Mallika Dixit
- Department of Pathology, Core Diagnostics, Gurgaon, Haryana India
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Pancsa T, Dénes B, Somorácz Á, Kelemen D, Salamon F, Sánta F, Kuthi L. Primary follicular dendritic cell sarcoma of the kidney - a case report of a rare tumor with emphasis on diagnostic pitfalls. Diagn Pathol 2024; 19:24. [PMID: 38297323 PMCID: PMC10829294 DOI: 10.1186/s13000-024-01444-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/15/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Follicular dendritic cell sarcoma (FDCS) is a rare low-grade tumor of the lymph nodes, but roughly one-third of the cases emerge from extranodal sites, posing diagnostic challenges. CASE PRESENTATION In this report, we present the case of a 59-year-old lady who complained of renal colic. During investigation, a kidney tumor was discovered. A radical nephrectomy was performed, and histological examination identified the tumor as a sarcomatoid renal cell carcinoma. The case was then referred to a genitourinary pathologist for further evaluation. The tumor cells exhibited positive staining for CD21, CD23, somatostatin receptor 2 A, and MDM2 expression. Additionally, MDM2 gene amplification was confirmed by the FISH study. Ultimately, the tumor was diagnosed as a primary renal FDCS. The patient was placed under active oncological surveillance and did not receive any further therapy. Remarkably, after 91 months of follow-up, she remains tumor-free. CONCLUSION This case represents a well-documented primary renal FDCS. Our aim in presenting this extremely rare tumor is to enhance awareness and highlight the importance of considering FDCS in the differential diagnosis.
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Affiliation(s)
- Tamás Pancsa
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás Street 1, Szeged, 6725, Hungary.
| | | | | | - Dóra Kelemen
- Pathology Unit, Uzsoki Street Hospital, Budapest, Hungary
| | - Ferenc Salamon
- Pathology Unit, Uzsoki Street Hospital, Budapest, Hungary
| | - Fanni Sánta
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás Street 1, Szeged, 6725, Hungary
| | - Levente Kuthi
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás Street 1, Szeged, 6725, Hungary.
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El Hussein S, Evans AG, Fang H, Wang W, Medeiros LJ. Unicentric Castleman Disease: Illustration of Its Morphologic Spectrum and Review of the Differential Diagnosis. Arch Pathol Lab Med 2024; 148:99-106. [PMID: 36920021 DOI: 10.5858/arpa.2022-0404-ra] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 03/16/2023]
Abstract
CONTEXT.— Unicentric Castleman disease (UCD) is a dynamic entity with a wide spectrum of morphologic findings. UCD can be further subdivided into hyaline-vascular and mixed/plasmacytic variants. Hyaline-vascular UCD has both follicular and interfollicular (stromal) changes, and occasionally these lesions show a skewed representation of either the follicular or stromal compartments. Plasmacytosis is usually minimal in the hyaline-vascular variant. The mixed/plasmacytic variant of UCD is composed of sheets of plasma cells often associated with a variable number of follicles with regressive changes. OBJECTIVE.— To illustrate the differential diagnosis of UCD, as it is quite broad and includes lymphomas, plasma cell neoplasms, stromal neoplasms such as follicular dendritic cell sarcoma and vascular neoplasms, immunoglobulin G4-related disease, infections, and other rare lesions. An additional objective is to enhance awareness of the morphologic features of UCD in excisional and in small core-needle biopsy specimens, the latter of which may inadvertently target follicle- or stroma-rich areas, causing diagnostic challenges. DATA SOURCES.— In this review, we provide readers a concise illustration of the morphologic spectrum of UCD that we have encountered in our practice and a brief discussion of entities in the differential diagnosis. CONCLUSIONS.— UCD exhibits a broad spectrum of morphologic changes, and awareness of these morphologic variations is key to avoid misdiagnosis.
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Affiliation(s)
- Siba El Hussein
- From the Department of Pathology, University of Rochester Medical Center, Rochester, New York (El Hussein, Evans)
| | - Andrew G Evans
- From the Department of Pathology, University of Rochester Medical Center, Rochester, New York (El Hussein, Evans)
| | - Hong Fang
- the Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston (Fang, Wang, Medeiros)
| | - Wei Wang
- the Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston (Fang, Wang, Medeiros)
| | - L Jeffrey Medeiros
- the Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston (Fang, Wang, Medeiros)
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Guo M, Nong L, Wang M, Zhang Y, Wang L, Sun Y, Wang Q, Liu H, Ou J, Cen X, Ren H, Dong Y. Retrospective cohort evaluation of non-HIV Castleman disease from a single academic center in Beijing, China. Ann Hematol 2024; 103:153-162. [PMID: 37749319 DOI: 10.1007/s00277-023-05472-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/20/2023] [Indexed: 09/27/2023]
Abstract
The purpose is to ascertain the clinical impact of Castleman disease (CD) by reassessment of the real-world data from Peking University First Hospital (PKUFH). The results will contribute to the standardization of diagnosis and treatment on CDs. Based on the last 15-year retrospective real-world data from Peking University First Hospital (PKUFH), we reclassified and re-evaluated the clinical and pathological information of patients with pathologically suspected diagnosis of CD. A total of 203 patients were included in our study, in which the diagnosis of CD was confirmed in 189 cases, including 118 patients with unicentric CD (UCD, n = 118, 62.4%) and 71 patients with multicentric CD (MCD, n = 71, 37.6%). A total of 44.1% (n = 52) of UCDs in our cohort were complicated with paraneoplastic pemphigus (PNP). The treatment of UCD is primarily surgical, with a 5-year overall survival (OS) of 88.1%. Patients with PNP had a poorer prognosis than those without PNP (82.9% (95% CI 123-178) vs 92.8% (95% CI 168-196), log-rank p = 0.041). The rate of concurrent systemic symptoms was 74.6% (n = 53), and renal involvement occurred in 49.3% (n = 35) MCD patients. The MCD treatments were mainly chemotherapy regimens, with a 5-year OS of 77.6% (95% CI, 143-213). Patients with UCD demonstrate a better overall prognosis than patients with MCD. But the prognosis of those complicated with PNP was poor. The differential diagnosis of MCD is extensive. MCD treatment in China is heterogeneous. The inaccessibility of anti-IL-6-targeted drugs in China may contribute to the poor prognosis for patients with MCD.A preprint has previously been published (Guo et al. 34).
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Affiliation(s)
- Meiyu Guo
- Department of Hematology, Peking University First Hospital, No. 7 Xishiku St. Xicheng District, Beijing, 100034, China
| | - Lin Nong
- Department of Pathology, Peking University First Hospital, Beijing, China
| | - Mingyue Wang
- Department of Dermatology, Peking University First Hospital, Beijing, China
| | - Yang Zhang
- Department of Hematology, Peking University First Hospital, No. 7 Xishiku St. Xicheng District, Beijing, 100034, China
| | - Lihong Wang
- Department of Hematology, Peking University First Hospital, No. 7 Xishiku St. Xicheng District, Beijing, 100034, China
| | - Yuhua Sun
- Department of Hematology, Peking University First Hospital, No. 7 Xishiku St. Xicheng District, Beijing, 100034, China
| | - Qingyun Wang
- Department of Hematology, Peking University First Hospital, No. 7 Xishiku St. Xicheng District, Beijing, 100034, China
| | - Huihui Liu
- Department of Hematology, Peking University First Hospital, No. 7 Xishiku St. Xicheng District, Beijing, 100034, China
| | - Jinping Ou
- Department of Hematology, Peking University First Hospital, No. 7 Xishiku St. Xicheng District, Beijing, 100034, China
| | - Xinan Cen
- Department of Hematology, Peking University First Hospital, No. 7 Xishiku St. Xicheng District, Beijing, 100034, China
| | - Hanyun Ren
- Department of Hematology, Peking University First Hospital, No. 7 Xishiku St. Xicheng District, Beijing, 100034, China
| | - Yujun Dong
- Department of Hematology, Peking University First Hospital, No. 7 Xishiku St. Xicheng District, Beijing, 100034, China.
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Zheng Y, Cao D, Shen Y, Xu L, Feng Q, Qiang W, Zhao E. Progressive abdominal pain with acute exacerbation due to retroperitoneal follicular dendritic cell sarcoma: a case report with targeted genomic sequencing analysis. Acta Chir Belg 2023; 123:707-711. [PMID: 36398705 DOI: 10.1080/00015458.2022.2145731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 11/05/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Follicular dendritic cell sarcoma (FDCS) is a rare malignancy that arises from follicular dendritic cells and typically presents as a slow-growing painless mass without specific symptoms. Here we report an unusual case of a 55-year-old female with retroperitoneal FDCS who presented with progressive abdominal pain onset and acute exacerbation. METHODS On CTA, a middle-upper abdominal mass (58*40 mm) was shown with multiple enlarged lymph nodes. After en-bloc resection of the tumor, the patient recovered completely from her symptoms and was discharged without complication. One month later, the patient returned for follow-up and the relevant tests were completed. RESULTS In this case, CA724 elevated significantly and seemed to be associated with tumor progression. The results of positron emission tomography/computed tomography (PET/CT) and radiological examinations, including magnetic resonance imaging (MRI) and computed tomography angiography (CTA), were discussed to improve our understanding of diagnostic tools on FDCS. Targeted genomic sequencing analysis revealed three novel gene mutations, EPHA3 (nonsense mutation), DDR2 (SNV), and BIRC3 (InDel). CONCLUSION We reported an unusual case of retroperitoneal FDCS with acute exacerbated abdominal pain. The interpretations of CA724, PET/CT, as well as imaging results deserve further investigation in FDCS. Genomic sequencing revealed three novel gene mutations in FDCS, including EPHA3 (nonsense mutation), DDR2 (SNV), and BIRC3 (InDel).
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Affiliation(s)
- Yihan Zheng
- Department of Gastrointestinal Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongxing Cao
- Department of Gastrointestinal Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanying Shen
- Department of Pathology, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lian Xu
- Department of Nuclear Medicine, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Feng
- Department of Radiology, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenyue Qiang
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Enhao Zhao
- Department of Gastrointestinal Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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13
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Chen S, Sun Y, Sun W, Dan M, Jiang Y. Survival analysis in patients with follicular dendritic cell sarcoma: a population-based study. Hematology 2023; 28:2260975. [PMID: 37732620 DOI: 10.1080/16078454.2023.2260975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/15/2023] [Indexed: 09/22/2023] Open
Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare low-intermediate grade malignant neoplasm. To date, published data on FDCS clinical courses are sparse, and no conditional survival study has been performed. Thus, we retrospectively analyzed 187 patients diagnosed with FDCS from the Surveillance, Epidemiology, and End Results (SEER) database. In this study, the median age at diagnosis was 50 years and 91 (48.7%) patients were male. The most common primary location was the abdomen/pelvis (82, 43.9%). The 1-year, 3-year, and 5-year overall survival (OS) were 88.7%, 69.0%, and 59.8%, respectively. The 5-year conditional overall survival increased from 65.7% at baseline to 83.8% in 5-year survivors. The 3-year FDCS-specific death rate was 26.7% and the rate of death from other reasons was 3.7%. In addition, the annual death hazard was the highest in the first four years after diagnosis and increased again in the 7th and 8th years. Age > 60 years at diagnosis, metastatic disease, and FDCS in thoracic organs were associated with shorter OS and FDCS-specific survival. In addition, FDCS patients, with either local or metastatic disease, could benefit from surgery therapy. In addition, adjuvant radiotherapy or chemotherapy for local disease provided no significant improvement in overall survival or FDCS-specific survival. We hope these findings may guide treatments and surveillance strategies for FDCS patients in clinical practice.
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Affiliation(s)
- Siyu Chen
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Yue Sun
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Wei Sun
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Min Dan
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Yongsheng Jiang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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14
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AbdullGaffar B, Keloth T. Extranodal Mesenteric Follicular Dendritic Cell Sarcoma Expressing Keratin Antigens: What Pitfalls Initiate Diagnostic Clues. Int J Surg Pathol 2023; 31:1308-1313. [PMID: 36572968 DOI: 10.1177/10668969221143470] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Extranodal follicular dendritic cell sarcomas are infrequent diagnostically challenging tumors. Because of their rarity, heterogeneous histomorphologic features and variable histologic grades a significant number of extranodal lesions are prone to be misdiagnosed. Even though they have a characteristic immunoprofile, expression of a range of nonspecific markers is well documented. Even though they are typically negative for keratins, few authors have reported lesions expressing keratin. Keratin expressing tumors are more likely to be misinterpreted by pathologists further deterring their inclusion in the differential diagnosis. We report an intraabdominal mesenteric follicular dendritic cell sarcoma in a 44-year-old male that immunophenotypically expressed keratin antigens. The lesion showed a high-grade pleomorphic epithelioid appearance and the initial differential diagnosis included lymphoma, sarcomas, melanoma, and carcinomas. Follicular dendritic cell sarcoma was not considered. Expression of epithelial membrane antigen and keratin further deterred the diagnosis which was reached only after extensive use of immunomarkers. The tumor cells expressed CD21, CD23, and D2-40. Morphologically, the tumor showed some thymoma-like features with occasional TDT-expressing background T-lymphocytes. These features were hints to reconsider our differential diagnosis to include follicular dendritic cell tumors. Awareness of this aberrant staining of epithelial immunomarkers and attention to certain clues should encourage pathologists to consider this entity. Speculative assumptions may explain this unusual keratin expression in some lesions. The histomorphologic and immunohistochemical heterogeneity may suggest different variants and grades of follicular dendritic cell sarcomas. The prevalence, importance, and histogenesis of keratin expression in follicular dendritic cell sarcomas warrant further studies.
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Affiliation(s)
| | - Tasnim Keloth
- Pathology Section, Dubai Hospital, Dubai, United Arab Emirates
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15
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Ji X, Dong A, Wang Y. FDG PET/CT in Follicular Dendritic Cell Sarcoma of the Jejunum With Hepatic Metastasis. Clin Nucl Med 2023; 48:902-904. [PMID: 37682607 DOI: 10.1097/rlu.0000000000004806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
ABSTRACT Follicular dendritic cell sarcoma of the gastrointestinal tract is a rare malignancy. We describe contrast-enhanced CT and FDG PET/CT findings in a case of jejunal follicular dendritic cell sarcoma with hepatic metastasis. The primary jejunal tumor showed inhomogeneous enhancement on contrast-enhanced CT and intense FDG uptake on PET/CT mimicking adenocarcinoma or gastrointestinal stromal tumor. The hepatic metastatic tumor showed hypovascularity on contrast-enhanced CT and mild FDG uptake on PET/CT. This case indicates that follicular dendritic cell sarcoma should be included in the differential diagnosis of the hypermetabolic intestinal lesions.
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Affiliation(s)
- Xia Ji
- From the Department of Gastroenterology, The Second Affiliated Hospital, Jiaxing University, Jiaxing
| | - Aisheng Dong
- Department of Nuclear Medicine, Changhai Hospital, Naval Medical University
| | - Yang Wang
- Department of Pathology, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
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16
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Pardasani M, Rajakannu M, Vij M, Rajalingam R, Rela M. Aggressive Variant of Hepatic Epstein-Barr Virus-Associated Inflammatory Pseudotumor-like Follicular Dendritic Cell Sarcoma with PD-L1 and SSTR2a Expression. Diagnostics (Basel) 2023; 13:2916. [PMID: 37761283 PMCID: PMC10529831 DOI: 10.3390/diagnostics13182916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/12/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
An aggressive Epstein-Barr virus (EBV)-associated inflammatory pseudotumor-like follicular dendritic cell (IPT-like FDC) sarcoma is reported in an adult female. The patient developed multifocal recurrence and passed away 13 months after the initial surgical resection. A bright field microscopic examination of the tumor demonstrated a classical growth pattern and the diffuse expression of Programmed death ligand 1 (PD-L1) and somatostatin receptor 2a (SSTR2a).
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Affiliation(s)
| | | | - Mukul Vij
- Rela Institute & Medical Centre, Chennai 6000044, India; (M.P.); (M.R.); (R.R.); (M.R.)
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17
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Yan S, Yue Z, Zhang P, Yuan L, Wang H, Yin F, Ju L, Chen L, Cai W, Ni Y, Wu J. Case report: Hepatic inflammatory pseudotumor-like follicular dendritic cell sarcoma: a rare case and review of the literature. Front Med (Lausanne) 2023; 10:1192998. [PMID: 37476617 PMCID: PMC10354642 DOI: 10.3389/fmed.2023.1192998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/06/2023] [Indexed: 07/22/2023] Open
Abstract
Inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS) is a rare subtype of follicular dendritic cell sarcoma (FDCS) that primarily occurs in the liver and spleen. The etiology of IPT-like FDCS is unknown, and it has nonspecific clinical manifestations, imaging performance and laboratory test results. Recently, a patient with IPT-like FDCS was admitted to our hospital because of abdominal distension and anemia. Over the past 3 years, the patient has been followed up after a liver mass was found in a physical examination. The lesion gradually enlarged and caused compression symptoms. In November 2022, a tumor with a diameter of approximately 20 cm was found in the right posterior lobe of the liver after abdominal enhanced Magnetic resonance imaging (MRI) in our hospital. Liver tumor biopsy before the operation revealed a large number of hyperplastic plasma cells and a small number of spindle cells, and the spindle cells were atypical. After a complete examination, the patient underwent liver resection. Pathology after surgery confirmed liver IPT-like FDCS.
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Affiliation(s)
- Shuai Yan
- School of Medicine, Nantong University, Nantong, Jiangsu, China
| | - Zhiqiang Yue
- School of Medicine, Nantong University, Nantong, Jiangsu, China
| | - Peng Zhang
- Institute of Liver Diseases, Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu, China
| | - Liuxia Yuan
- Institute of Liver Diseases, Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu, China
| | - Huixuan Wang
- Institute of Liver Diseases, Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu, China
| | - Fei Yin
- Department of Nail and Breast Surgery, Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu, China
| | - Linglin Ju
- Institute of Liver Diseases, Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu, China
| | - Lin Chen
- Institute of Liver Diseases, Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu, China
| | - Weihua Cai
- Department of Hepatobiliary Surgery, Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu, China
| | - Yi Ni
- Department of Nail and Breast Surgery, Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu, China
| | - Jinzhu Wu
- Department of Hepatobiliary Surgery, Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu, China
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18
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Auerbach A, Girton M, Aguilera N. Controversies in the Spleen: Histiocytic, Dendritic, and Stromal Cell Lesions. Surg Pathol Clin 2023; 16:385-400. [PMID: 37149364 DOI: 10.1016/j.path.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Histiocytic, dendritic, and stromal cell lesions that occur in the spleen are challenging diagnostically, not well studied due to their rarity, and therefore somewhat controversial. New techniques for obtaining tissue samples also create challenges as splenectomy is no longer common and needle biopsy does not afford the same opportunity for examination of tissue. Characteristic primary splenic histiocytic, dendritic, and stromal cell lesions are presented in this paper with new molecular genetic findings in some entities that help differentiate these lesions from those occurring in non-splenic sites, such as soft tissue, and identify possible molecular markers for diagnosis.
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Affiliation(s)
| | - Mark Girton
- University of Virginia Health System, Charlottesville, VA, USA
| | - Nadine Aguilera
- University of Virginia Health System, Charlottesville, VA, USA.
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19
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Phrathep DD, Healey KD, Anthony S, Fives KR, Boshkos MC, Galani R. Mediastinal Follicular Dendritic Cell Sarcoma With Underlying Sjogren's Syndrome. Cureus 2023; 15:e37715. [PMID: 37206482 PMCID: PMC10191452 DOI: 10.7759/cureus.37715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/21/2023] Open
Abstract
Follicular dendritic cells help advance B-Cells in becoming memory B-Cells or antibody-producing plasma cells in the light zone, or undergo additional affinity maturation in the dark zone. Follicular dendritic cell sarcoma (FDCS) is an extremely rare soft tissue malignancy derived from follicular dendritic cells. Autoimmune disease increases the risks for the development of hematological malignancies. To the best of our knowledge, there are few cases of FDCS development in the setting of underlying Sjogren's syndrome (SS). Therefore, in this report, we present a novel case of FDCS associated with new-onset SS. In SS, the follicular dendritic cells are organized within germinal centers within the glands it infiltrates and is involved in B-Cell development. Because FDCS is derived from follicular dendritic cells, our report postulates that the unregulated follicular dendritic cell proliferation that may occur in SS could increase the risk for FDCS. Due to this possible connection observed in our patient, we highlight FDCS as a differential diagnosis when considering soft tissue cancers. We urge additional research to outline and explore the possible pathologic link between SS and FDCS.
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Affiliation(s)
| | - Kevin D Healey
- Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Stefan Anthony
- Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Kaila R Fives
- Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Mitchell C Boshkos
- Internal Medicine, Lake Erie College of Osteopathic Medicine, Akron, USA
| | - Ruple Galani
- Cardiology, Baptist Medical Center Beaches, Jacksonville, USA
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20
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Li M, Xing R, Huang J, Shi C, Wei C, Wang H. Case report: Epithelioid inflammatory myofibroblastic sarcoma treated with an ALK TKI ensartinib. Front Oncol 2023; 13:1084456. [PMID: 37035183 PMCID: PMC10073548 DOI: 10.3389/fonc.2023.1084456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is an aggressive variant of inflammatory myofibroblastic tumor (IMT) and has a poor prognosis. EIMS is characterized by epithelioid morphology, neutrophilic infiltrate and specific fusion partners of anaplastic lymphoma kinase (ALK). Despite no standard therapy for EIMS, ALK tyrosine kinase inhibitors (TKIs) are recommended for these tumors. The present case describes an abdominal mass that presented in a 31-year-old male. The patient suffered from recurrence and multiple metastases 2 months after surgery. Ensartinib was administered and RANBP2-ALK fusion was detected. A partial response has been observed for 4 months and there has been no recurrence. This study provided a successful case with sustained response of targeted therapy.
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Affiliation(s)
- Mengmeng Li
- Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Caner Hospital, Zhengzhou, China
| | - Ruyue Xing
- Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Caner Hospital, Zhengzhou, China
| | - Jiuyan Huang
- Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Caner Hospital, Zhengzhou, China
| | - Chao Shi
- Department of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
| | - Chunhua Wei
- Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Caner Hospital, Zhengzhou, China
| | - Huijuan Wang
- Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Caner Hospital, Zhengzhou, China
- *Correspondence: Huijuan Wang,
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21
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Leng DN, Yu KJ, Wang J. Inflammatory pseudotumor-like follicular dendritic cell sarcoma with first clinical manifestation of thrombocytopenia: A case report. Medicine (Baltimore) 2022; 101:e32528. [PMID: 36596072 PMCID: PMC9803453 DOI: 10.1097/md.0000000000032528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS) is often associated with Epstein-Barr (EB) virus infection. The tumor is commonly found in the spleen and liver, and it has been reported in the literature that it can be associated with paraneoplastic pemphigus, myasthenia gravis, and other diseases. A case of IPT-like FDCS with clinical features of thrombocytopenia has not been reported. PATIENT CONCERNS A 59-year-old male patient visited our hospital in September 2020 due to bleeding gums and epistaxis. DIAGNOSIS Splenic lymphoma with marked thrombocytopenia was initially diagnosed. The patient underwent pathological examination after splenectomy. Microscopic examination showed spindle-shaped or oval cells arranged in loose bundles, a large number of lymphocytes and plasma cells infiltrating the interstitium, and fibrin-like changes in the blood vessel wall. Immunohistochemical detection of tumor cells was positive for CD21, CD35, and Epstein-Barr virus in situ hybridization, and the patient was diagnosed with IPT-like FDCS. INTERVENTIONS The patient underwent a splenectomy. The patient received platelet-raising therapy postoperatively. OUTCOMES No tumor recurrence or metastasis was found during the 17-month follow-up period, and the platelet count returned to normal. CONCLUSION IPT-like FDCS is an uncommon tumor, and its first presentation with marked thrombocytopenia is even rarer. The tumor was clinically and radiographically nonspecific. Definitive diagnosis relies on histopathological and immunohistochemical staining. IPT-like FDCS is biologically indolent and has a favorable prognosis.
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Affiliation(s)
- Dong Ni Leng
- Pathology department, Nanjing JunXie Hospital, Nanjing, China
| | - Kang-Jie Yu
- Pathology department, Nanjing JunXie Hospital, Nanjing, China
| | - Jing Wang
- Translational Medicine Center, Nanjing JunXie Hospital, Nanjing, China
- * Correspondence: Jing Wang, Translational Medicine Center, Nanjing JunXie Hospital, 32# MA-Lu street, Nanjing, Jiangsu Province 210002, China (e-mail: )
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22
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Ding F, Wang C, Xu C, Tang H. Case report: Hepatic inflammatory pseudotumor-like follicular dendritic cell sarcoma: A rare case and minireview of the literature. Front Med (Lausanne) 2022; 9:1002324. [PMID: 36425103 PMCID: PMC9679012 DOI: 10.3389/fmed.2022.1002324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
Inflammatory pseudotumor (IPT)-like follicular dendritic cell sarcoma (FDCS) is a rare neoplasm referred to as the FDCS variant. Here we report a 66-year-old female patient suffering from hepatic IPT-like FDCS and summarize IPT-like FDCS reported in the literature. The patient presented with obvious abdominal pain without significant laboratory abnormalities and subsequently underwent surgical resection of a hepatic lesion. Postoperative pathological results demonstrated a vascular tissue-rich neoplasm (7.0-cm maximum diameter). The tumor cells expressed CD21 and CD35, and in situ hybridization detected Epstein–Barr virus-encoded RNA (EBER). Metastasis or recurrence was not detected during the 7-year follow-up.
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Affiliation(s)
- Fan Ding
- Center of Gallbladder Disease, East Hospital of Tongji University, Shanghai, China
- Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China
| | - Chao Wang
- Department of Radiology, Nanxiang Hospital of Jiading District, Shanghai, China
| | - Chi Xu
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Organ Transplantation Institute, Sun Yat-sen University, Guangzhou, China
- Chi Xu,
| | - Hui Tang
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Organ Transplantation Institute, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Hui Tang,
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23
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V V, Bansal S, Purwar P, Dewan RK, Verma P, Mullick S, Dixit M, Phanindra BR, Siddhartha K. Thoracic follicular dendritic cell sarcoma - an outlandish presentation of a rare tumour with review of literature. Monaldi Arch Chest Dis 2022; 93. [PMID: 36128928 DOI: 10.4081/monaldi.2022.2360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
Follicular dendritic cell sarcoma is a rare low grade malignant neoplasm that arises from follicular dendritic cells in lymphoid tissue germinal centres and accounts for 0.4% of all soft tissue sarcomas. It is extremely rare to have pulmonary follicular dendritic cell sarcoma with endobronchial extension and as an anterior mediastinal mass with mediastinal lymph node involvement. We present the case of a 34-year-old male non-smoker who had been experiencing chest pain for three months. A lobulated left peri-hilar mass with endobronchial spread into the left main bronchus and mediastinal lymphadenopathy was identified on a chest CT. The bronchoscope-guided cryobiopsy of the endobronchial mass was inconclusive. After a thorough multidisciplinary discussion, the patient underwent left sided pneumonectomy, mediastinal mass resection, and systematic lymph node dissection. Histologic examination using immunohistochemistry revealed follicular dendritic cell sarcoma.
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24
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Takeuchi K. Idiopathic plasmacytic lymphadenopathy: A conceptual history along with a translation of the original Japanese article published in 1980. J Clin Exp Hematop 2022; 62:79-84. [PMID: 35768240 PMCID: PMC9353855 DOI: 10.3960/jslrt.22011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The current consensus on Castleman disease is that it is a group of several distinct lymphoproliferative disorders with different underlying pathogenesis and clinical outcomes. In 1980, Mori et al. proposed the concept of idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia (IPL), a disease of unknown etiology, characterized by severe polyclonal hypergammaglobulinemia and generalized superficial lymphadenopathy. After Frizzera et al.’s landmark report in 1983, the term multicentric Castleman disease (MCD) gradually became established, and for a time, IPL was regarded as identical to MCD. However, with the subsequent recognition of human herpesvirus 8 (HHV8)-related MCD in the 1990s and the contributions by Kojima et al. in the 2000s, in which non-HHV8-related MCD (now called idiopathic MCD) was at least subclassified into IPL and others (non-IPL), it is now clear that the original distinctiveness of IPL is still maintained in MCD, which is a diverse collection of diseases.
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Affiliation(s)
- Kengo Takeuchi
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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25
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Xiao N, Xiao S, Yang W. Follicular dendritic cell sarcoma of the nasopharynx: a case report and literature review. J Int Med Res 2022; 50:3000605221097662. [PMID: 35549581 PMCID: PMC9112826 DOI: 10.1177/03000605221097662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Follicular dendritic cell sarcoma (FDCS) of the nasopharynx is a rare malignant tumor that has been described in only a few case reports, and its differential diagnoses include diverse clinicopathologic entities. FDCS is often initially misdiagnosed, especially when examining small biopsy specimens. We herein report a case of FDCS arising in the nasopharynx that was initially misdiagnosed as a nerve sheath tumor. A 44-year-old woman presented with persistent obstruction of the left nasal cavity and underwent an excisional biopsy. The specimen demonstrated morphologic and immunohistochemical features of FDCS. In situ hybridization for Epstein–Barr virus-encoded RNA was negative. The patient was treated with chemotherapy and radiotherapy. The sarcoma recurred near the original site more than 3 years after the initial treatment and was completely resected. At the time of this writing, the patient had remained disease-free for 1 year after resection. This case is being reported to improve the clinical recognition of FDCS.
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Affiliation(s)
- Na Xiao
- Master Degree Candidate, Department of Pathology, Xiantao First People's Hospital of Yangtze University, Xiantao, China
| | - Shubing Xiao
- Undergraduate, Department of Pathology, Xiantao First People's Hospital of Yangtze University, Xiantao, China
| | - Wei Yang
- Undergraduate, Department of Gastroenterology, Xiantao First People's Hospital of Yangtze University, Xiantao, China
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26
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Chen N, Ba W, Zhao D, Sheng L, Zhang X. Response of Tonsil Follicular Dendritic Cell Sarcoma to Multimodal Treatment Including Pembrolizumab: A Case Report and Literature Review. Front Oncol 2022; 12:816903. [PMID: 35299752 PMCID: PMC8922364 DOI: 10.3389/fonc.2022.816903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare malignant neoplasm that was classified by the World Health Organization (WHO) under histiocytic and dendritic cell neoplasms in the 2016 revision. Considering the rarity of this tumor, there is no standardized treatment. It is usually treated by complete surgical resection. Adjuvant chemotherapy and radiotherapy are alternative methods. Immune checkpoint inhibitors (ICIs) represented by the programmed death receptor 1/programmed death ligand 1 (PD-1/PD-L1) antibody have achieved significant clinical benefits in a variety of solid tumors. However, reports on the treatment of FDCS with ICIs are rare. FDCS often expresses high levels of PD-L1, which provides a rationale to use immunotherapy in cases of FDCS. Here, we present a 51-year-old Filipino-Chinese man with FDCS who was treated with multimodal treatment, including the PD-1 inhibitor pembrolizumab and achieved a relatively long disease-free survival of 24 months. This case emphasizes that the application of ICIs under the guidance of NGS technology seems to be a meaningful treatment option for patients with FDCS.
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Affiliation(s)
- Nanxiang Chen
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, National Clinical Research Center for Otolaryngologic Diseases, State Key Lab of Hearing Science, Ministry of Education, Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Wei Ba
- Department of Pathology, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China
| | - Dawei Zhao
- Department of Radiation Oncology, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China
| | - Lei Sheng
- Department of Anesthesiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Xinxin Zhang
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, National Clinical Research Center for Otolaryngologic Diseases, State Key Lab of Hearing Science, Ministry of Education, Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
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