Clinicopathological characteristics and differential diagnosis of interdigitating dendritic cell sarcoma / 中华肿瘤杂志

Objective@#To analyze the clinicopathological features and differential diagnosis of interdigitating dendritic cell sarcoma (IDCS).@*Methods@#The clinical pathological features of 7 IDCS were analyzed. Among them, the follow-up results of 6 cases were available.@*Results@#Among the 7 IDCS patients, 4 cases were male and 3 were female. The age of the patients ranged from 26 to 69 years.Three cases were originated from lymph nodes and 4 cases were originated from skin, stomach, adrenal gland and mesentery, respectively. Microscopically, the tumor cells presented as fascicular and storiform proliferation and infiltrated by lymphocytes. The tumor cells were short-spindle or ovoid, with indistinct border of cytoplasm. The immunohistochemistry results showed that tumor cells were S-100, Vim, CD68 and CD163 positive, and AE1/AE3, EMA, CD117, CD34, Desmin, SMA, CD1α, CD21, CD23, CD35, HMB45, Melan-A, MelanPan and ALK negative.The BRAF mutation and clonal rearrangement of T and B cells were not detected. Among the follow-up period of 7 IDCS patients, 3 occurred disease progressions.@*Conclusions@#IDCS is extremely rare with unique pathological features, and its lesion is not limited to the lymph node. The IDCS patients with extensive lesions may have worse prognose. The differential diagnosis of IDCS includes other histiocytic and dendritic cell neoplasms, malignant melanoma and soft tissue neoplasms.

A Study on Variations of Nutrient Foramen of Fibula in Saurashtra Region with its Clinical Relevance

Introduction: Nutrient foramen is an opening into shaft of fibula which gives passage to the blood vessels of medullary cavity. The knowledge of nutrient foramen is important in surgical procedures like bone grafting and more recently in microsurgical vascularized bone transplantation. Objective: To determine the number, location and direction of nutrient foramen and whether the nutrient foramens obey the rule of ossification, that is directed away from the growing end of the bone or not. Subjects and Methods: The present study consisted of 150 (75 right and 75 left) dried fibula bones excluding any fracture or pathological abnormalities Number and direction of nutrient foramen was observed in each fibula. Location of nutrient foramen in relation with surfaces and zones of fibula was determined. Results: It has been observed that 96.67% of the fibula had a single nutrient foramen, 3.33% double foramen and no bone had 0 nutrient foramen. It was concluded that 98.71% of the nutrient foramina were present on the posterior surface and 1.29 % on medial crest. It was also concluded that most (98.06%) of the foramina present in the zone II followed by zone III (1.29%) then by zone I (0.65%). All foramina were directed toward the upper end of fibula. Conclusion: By knowing the number and location of the nutrient foramina in fibula would be useful in preventing intra-operative injury of nutrient artery during orthopedic, plastic and reconstructive surgery and will also be relevant in medico legal practice.

The Morphology and Clinical Considerations of Mucosal Folds of Cystic Duct

Introduction: The cystic duct connects the gallbladder to the extra hepatic bile duct. In its endoluminal surface are the mucosal folds which are characteristic of the duct. Aim:-The aim was to study the length and mid-length diameter of the cystic duct and the mucosal folds of its endoluminal surface with respect to their number, location, and orientation. Subjects and Methods: This study was carried out in the Anatomy Department of Parul Institute of Medical Sciences and Research, Vadodara, on 40 specimens of 10% formalin fixed human cystic ducts, from 2015 to 2018, after obtaining permission from the Institutional Ethics Committee. The cystic duct was isolated and its lumen was exposed by an incision parallel to its length to study the folds. Results: The length of the cystic duct was between 0.4 to 4.2 cm, and the diameter was between 0.2-0.6cm. The mucosal folds were present in 38(95%) specimens and were absent in two (5%). The maximum number of mucosal folds present in a specimen was eleven. In the 25 (62. 5%) specimens they spanned the entire length and in 13(32.5%) they were present only in the proximal part. Their disposition was either oblique, transverse interdigitating, combination type or saccular. Conclusion: It gives insight into the internal morphology of the cystic duct. Various types of mucosal folds have been described, the knowledge of which will be important to the laparoscopic surgeons during various interventional approaches undertaken in this region.

Diagnosis and treatment progress of interdigitating dendritic cell sarcoma / 肿瘤研究与临床

Interdigitating dendritic cell sarcoma (IDCS) is a very rare hematopoietic tissue-derived dendritic cell malignancy. Because of the lack of specific clinical manifestations, pathological diagnosis is still the gold standard for the diagnosis of IDCS. However, there are no standard treatment programs of IDCS at present. Most reports in the literatures on single tumor mainly focus on surgery. And for patients with multiple metastases and relapses in the body, chemotherapy is the major treatment method. IDCS is characterized with high malignancy, rapid clinical progress and poor prognosis. This paper reviews the progress of IDCS diagnosis and treatment.

Sarcoma diseminado de células dendríticas interdigitantes / Disseminated interdigitating dendritic cell sarcoma

Se describe el caso de una mujer de 70 años que consultó por dolor abdominal asociado a pérdida de peso y sudoración nocturna. En el examen físico se destacaban una masa abdominal comprendida entre el epigastrio y el flanco izquierdo, de unos 5 cm de diámetro, duro-elástica, móvil e indolora, y al menos tres adenopatías supraclaviculares bilaterales de 2 cm de diámetro, duras y adheridas a planos profundos. Se realizó una biopsia de la masa abdominal, con lo que se diagnosticó un sarcoma de células dendríticas interdigitantes. Se inició quimioterapia con el esquema CHOP (ciclofosfamida, doxorrubicina, vincristina y prednisona). Falleció luego de completado el primer ciclo del tratamiento, a los seis meses del diagnóstico.

A 70 year-old woman was admitted to our hospital with a 3-month history of abdominal pain, weight loss and night sweats. On physical examination, she presented with a 5 cm diameter abdominal mass extended from epigastrium to the left flank, and at least three bilateral supraclavicular adenopathies. A disseminated interdigitating dendritic cell sarcoma was diagnosed through a biopsy of the abdominal mass. After that, a CHOP regime (cyclophosphamide, doxorubicin, vincristine and prednisone) was iniciated. She died after completion of the first cycle of treatment, six months after diagnosis.

A Case of Disseminated Extranodal Interdigitating Dendritic Cell Sarcoma Arising from Parotid Gland / 고신대학교의과대학학술지

Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare tumor derived from professional antigen presenting cell and primarily found in lymph nodes, with rarer case report about extranodal presentation of IDCS. A 71-yr-old man was admitted with progressively enlarging and painless mass in the right parotid area for 2 months. Computed tomography of the neck and chest revealed enhancing mass in right parotid gland, multiple lymphadenopathies around neck and mediastinum, and an osteolytic metastasis at thoracic spine. Morphological and immunohistochemical analysis of an excisional biopsy specimen from parotid mass were consistent with a diagnosis of IDCS. Palliative chemotherapy with 6 cycles of CHOP (cyclophosphamide, adriamycin, vincristine, and prednisolone) regimen and 2 cycles of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine) regimen plus radiotherapy on parotid mass failed in tumor reduction. We describe a rare case of disseminated extranodal IDCS arising from parotid gland.

Characteristics,diagnosis and treatment of interdigitating dendritic cell sarcoma / 国际肿瘤学杂志

Interdigitating dendritic cell sarcoma (IDCS)is a rare malignant tumor of the dendritic cell, derived from the hematopoietic tissue.The major clinical manifestation of IDCS is superficial lymphadenopathy, and the enlarged lymph nodes may appear in some atypical ereas,such as the lung,kidney,bladder and the pleura,etc.With the development of the pathological diagnosis and the application of immunohistochemical staining and electron microscopes,the case detection rate is apparently improved.With the high degree of malignant,rapid progress and poor prognosis of the disease,currently,surgical therapy is still the main approach to the treatment of IDCS.

Interdigitating dendritic cell sarcoma occured alone in axilla / 대한외과학회지

Interdigitating dendritic cell sarcoma (IDCS) is a very rare disease around the world and its prognosis is known to be aggressive. This reports a case diagnosed as IDCS of the axillary region treated in Soonchunhyang University Hospital. A 57-year-old female visited Soonchunhyang University Hospital with a left axillary mass. The mass was hard and fixed. Computed tomography observed a 7 cm lymph node at the left axilla, and core biopsy suspected sarcoma. In another study, there was no specific finding except the axillary lesion. Left axillary lymph node dissection (level I, II) was conducted and the pathologic report finally showed IDCS. The patient was treated with only radiotherapy and followed up without recurrence for 13 months up to now. IDCS is a very rare sarcoma that is hard to diagnose and progresses fast. Thus, treatment is very difficult. Proper treatment can be better established after more experiences.

One case of interdigitating dendritic cell sarcoma concurrent with acute myelomonocytic leukemia and literatures review / 白血病·淋巴瘤

Objective To summarize and learn the biological properties and clinical features of interdigitating dendritic cell sarcomas (IDCS).Methods The first IDCS patient concurrent with acute myelomonocytic leukemia (AML-M4) described herein,to our knowledge,was studied and 62 IDCS cases reported previously in the literature were reviewed.Results The patient had a history of breast cancer as well as radiotherapy and chemotherapy of it,and the patient showed poor response to 4 cycles of sequential chemocherapy regimens.Based on the laboratory results,IDCS and AML-M4 in this patient were both of myelogenous origination.Furthermore,review of the 62 IDCS patients reported previously showed that as high as 17 ％ of the patients had malignant disease and received radiotherapy or chemotherapy before they got IDCS,and patients of this group had worse prognosis compared with counterpart.Conclusion IDCS has poor prognosis,and therapy-related type worse.Prophylactic measures and stringent screening of the second cancer in those who received chemoterapy or radiotherapy are appropriated and necessary.

Extranodal Interdigitating Dendritic Cell Sarcoma Presenting in the Pleura: A Case Report

Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare neoplasm arising from the antigen-presenting cells of the immune system. This disease usually involves the lymph nodes, and rarely, extranodal sites may be affected. The authors report a case of extranodal IDCS presenting in the pleura. A 32-yr-old man presented with progressive chest pain. Imaging studies showed diffuse pleural thickening with pleural effusion. Morphological and immunohistochemical analysis of an incisional biopsy of the pleura were consistent with a diagnosis of IDCS; tumor cells were positive for S100 and CD45, but negative for CD1a, CD21, CD35, B cell and T cell markers. The patient was administered chemotherapy, but died of progressive disease. Although its incidence is extremely rare, this case suggests that extranodal IDCS should be considered in the differential diagnosis of undifferentiated neoplasms and that immunohistochemical staining be performed using appropriate markers.

Immunohistochemical analysis for CD21, CD35, Caldesmon and S100 protein on dendritic cells types in oral lymphomas

OBJECTIVE: Follicular dendritic cells (FDCs) and interdigitating dendritic cells (IDCs) are dendritic cells found in lymphoid follicles, reactive follicles and in lymphomas. The goal of this study was to evaluate the presence and distribution of FDCs and IDCs in oral lymphomas. MATERIAL AND METHODS: Immunohistochemistry reactions were applied to 50 oral lymphomas using the antibodies anti-CD21, anti-CD35 and anti-caldesmon to FDCs, and anti-S100 protein to IDCs. Caldesmon+/FDCs and S100+/IDCs were quantified in Imagelab® software. RESULTS: FDCs revealed by CD21 and CD35 were positively stained in two cases of diffuse large B-cell lymphoma, one MALT lymphoma, and in one case of mantle cell lymphoma. FDCs were immunopositive to caldesmon in all cases, as well as IDCs to S100 protein. Burkitt lymphoma presented a lower amount of caldesmon+/FDCs and S100+/IDCs than diffuse large B-cell lymphoma and plasmablastic lymphoma of the oral mucosa type. CONCLUSIONS: The microenvironment determined by neoplastic lymphoid cells in oral lymphomas is responsible by the development and expression of dendritic cells types.

Expression of the p75NTR Neurotrophin Receptor in the Thymic Medullary Epithelial Cells and Interdigitating Dendritic Cells during Rat Thymus Regeneration Following Acute Thymic Involution / 대한해부학회지

The existence of a functional link between the nervous and immune systems has been well established. The present study was to characterize the expression of p75NTR during thymus regeneration from acute involution induced by cyclophosphamide in the rat. Immunohistochemical and double immunofluorescence analyses demonstrated that expression of the p75NTR was decreased in the thymic medullary epithelial cells and interdigitating dendritic cells during thymus regeneration. The presence of p75NTR protein in extracts from the control and regenerating rat thymus was confirmed by western blot. Furthermore, RT-PCR analysis supported these results by demonstrating that thymic extracts contain p75NTR mRNA at lower levels during thymus regeneration. Thus, our results suggest that the p75NTR located on the thymic medullary epithelial cells and interdigitating dendritic cells could play a role in the development of new T cells to replace the thymocytes damaged during thymus regeneration

Interdigitating Reticulum Cell Sarcoma of Lymph Node / 대한이비인후과학회지

Interdigitating reticulum cell sarcoma is a neoplasm that shows differentiation similar to that of non-neoplastic interdigitating reticulum cells, which normally reside in the paracortical region of the lymph node. Interdigitating reticulum cell sarcoma is extremely rare and its definite identification requires a multiparameter study, including microscopic, enzymatic histochemical, immunophenotypic and molecular findings of the tumor cells. We report a case of interdigitating reticulum cell sarcoma in the right upper jugulodigastric lymph node of a 42-year-old male. The patient wad initially diagnosed as metastatic undifferentiated carcinoma, so we tried to find primary site but failed. The patient was treated by radiation therapy under the diagnosis of metastatic neck node. Two years later, the patient was finally diagnosed to interdigitating reticulum cell sarcoma by pathological review and immunohistochemical studies. The patient has been alive well at 55 month of follow-up.

Interdigitating Reticulum Cell Sarcoma of Lymph Node

We report a case of reticulum cell sarcoma in the right cervical lymph node of a 42-year-old male. It was a slowly growing, non-tender movable mass of 8 months duration. Microscopically, the lymph node was effaced by proliferating spindle cells arranged in broad sheets, bands, or fascicular patterns in paracortical area sparing of B-cell region. The tumor component was divided by fibrous band. The individual cells had oval to round or elongated nuclei, with inconspicuous nucleoli and moderate amounts of cytoplasms with indistinct cell borders. Pleomorphic large cells with binucleated, or multinucleated bizarre nuclei with prominent nucleoli, were partly admixed. In immunohistochemical stain, the tumor cell was strong positive for S-100 protein, HLA-DR, Mac387 and weakly positive for Leukocyte common antigen and equivocal for Vimentin. But it was negative for CD21, Ki-1, Desmin, Epithelial membrane antigen and Cytokeratin. These immunohistochemical findings suggested that the neoplastic cell was originated from the interdigitating reticulum cell of lymph node. The patient was treated by radiation therapy, and alive well at 37 months of follow-up.