Follicular dendritic cell sarcoma

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Follicular dendritic cell sarcoma
Diagnosis in short

LM oval or spindle-shaped cellular & nuclear morphology, variable architecture (sheets, fascicles, whorles, storiform pattern), nuclei with small nucleoli and clear or dispersed chromatin, multinucleated cells, interspersed small lymphocytes, +/-necrosis, +/-marked nuclear atypia, +/-abundant mitoses.
LM DDx histiocytic sarcoma, thymoma, other spindle cell lesions
IHC CD21 +ve, CD35 +ve, Ki-M4p +ve, Ki-FDRC1p +ve, vimentin +ve
Associated Dx Castleman disease, hyaline-vascular type
Prevalence very rare
Treatment excision

Follicular dendritic cell sarcoma, abbreviated FDCS, is a very rare malignant tumour.

It is also known as follicular dendritic cell tumour (abbreviated FDCT).[1]

Other possible names are: dendritic reticulum cell sarcoma, (???) follicular dendritic cell neoplasm. (???)

General

  • Very rare.
  • Behave like a low-grade sarcoma.[2]
  • Reported association with Castleman disease (hyaline-vascular type).[2]

Microscopic

Features:[2]

  • Oval or spindle-shaped cellular & nuclear morphology.
  • Variable architecture (sheets, fascicles, whorles, storiform pattern).
  • Nuclei:
    • Small nucleoli.
    • Clear or dispersed chromatin.
  • Multinucleated cells.
  • Interspersed small lymphocytes - distinctive feature.
  • +/-Necrosis.
  • +/-Marked nuclear atypia.
  • +/-Abundant mitoses.

DDx:

Images

IHC

Features:[2]

  • CD21 +ve.
  • CD35 +ve.
  • Ki-M4p +ve
  • Ki-FDRC1p +ve.
  • Vimentin +ve.
  • S-100 +ve/-ve.
  • Muscle-specific actin +ve/-ve.
  • EMA +ve/-ve.

See also

References

  1. 1.0 1.1 Leipsic, JA.; McAdams, HP.; Sporn, TA. (Jun 2007). "Follicular dendritic cell sarcoma of the mediastinum.". AJR Am J Roentgenol 188 (6): W554-6. doi:10.2214/AJR.04.1530. PMID 17515347.
  2. 2.0 2.1 2.2 2.3 Perez-Ordoñez, B.; Rosai, J. (May 1998). "Follicular dendritic cell tumor: review of the entity.". Semin Diagn Pathol 15 (2): 144-54. PMID 9606805.
  3. Alexiev, BA.; Sailey, CJ.; McClure, SA.; Ord, RA.; Zhao, XF.; Papadimitriou, JC. (2007). "Primary histiocytic sarcoma arising in the head and neck with predominant spindle cell component.". Diagn Pathol 2: 7. doi:10.1186/1746-1596-2-7. PMID 17324277. http://www.diagnosticpathology.org/content/2/1/7.
  4. URL: http://www.npplweb.com/wjsmro/fulltext/2/1. Accessed on: September 13, 2014.