ABSTRACT
To explore the clinicopathological and immunohistochemical characteristics of follicular dendritic cell sarcoma(FDCS)and the expressions of IgG and IgG4. We retrospectively analyzed the clinicopathological and immunohistochemical data of 9 pathologically confirmed FDCS cases in Peking Union Medical College Hospital from January 2005 to December 2018.Immunohistochemical staining of IgG and IgG4 were performed,and Epstein-Barr virus(EBV)-encoded RNA(EBER)in situ hybridization were carried out. Nine cases of FDCS included 4 men and 5 women aged 16-53 years [mean(38.2±9.7)years].The clinical manifestations included masses,lymph node enlargement,rash,and fever.The tumors were located in lymph node,retroperitoneal region,adrenal gland,neck,axillary region,and liver,respectively.Ultrasound showed clear boundary cystic or solid mass with maximum diameters of 1.5-15.0 cm.Microscopically,the spindle tumor cells were arranged in solid and storiform patterns with abundant and slightly stained cytoplasm,vacuolated nuclei,and small nucleoli.The mitosis was 1-3/10 high power fields,and necrosis was found in 5 cases.Immunohistochemically,the tumor cells were positive for CD21(6/9),CD35(6/9),and CD23(7/9). FDCS is a rare malignant tumor,which is easy to be missed.The combination of CD21,CD35,and CD23 is helpful for diagnosis.Hyaline-vascular type Castleman's disease may be the precursor of FDCS,and there may be only a small number of IgG4-positive plasma cells in FDCS.Surgical resection remains the main treatment for FDCS.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Dendritic Cell Sarcoma, Follicular , In Situ Hybridization , Liver , Lymph Nodes , Retrospective StudiesABSTRACT
Background and purpose:Angiofollicular lymphoid hyperplasia(Castleman's disease,CD) is a rare kind of abnormal disease with lymphoid hyperplasia. We analyzed the clinical data of 21 patients with pathologically-confirmed CD. Methods:Twenty-one cases,including 10 males and 11 females with a mean age of 38.6 years,with CD were collected from January 1971 to December 2007 in this study. The disease was divided into localized type(n=19) and disseminated type(n=2) . The clinical data,CT images and pathological and surgical results were restrospectively analyzed. Results:All cases were categorized as hyaline vascular type. In 19 cases with localized type of CD,the lesion presented as a solitary soft-tissue mass with a mean diameter of 5.2 cm,located at the left and right hilus of the lung(n=3 and 2 respectively) or in the interior lung(n=3) ,in the thoracic wall(n=2) or in the mediastinum(n=9) . Two cases of disseminated type were characterized by many groups of thoracic lymphadenopathy with a mean diameter of 2.3 cm,without other organ involvement. On plain CT scan,the mean CT value was 42 Hu. After contrast administration,obvious homogeneous enhancement was observed in arterial phase with CT value of 112 Hu. The preoperative misdiagnosis by CT was 90.5%. Conclusion:CD have no specifi c CT characteristic,its verifi cation is mainly based on pathologic examination. Surgical resection for localized type of CD is curative,but for disseminated CD,multidisciplinary therapies are recommended.