scholarly journals Imaging features of inflammatory pseudotumor-like follicular dendritic cell sarcoma of the spleen

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Nianyu Xue ◽  
Xiaogang Xue ◽  
Changrui Sheng ◽  
Minli Lu ◽  
Yifei Wang ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lingbin Xu ◽  
Rong Ge ◽  
Shanshan Gao

Abstract Background Inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS) is a rare tumor. This study aimed to reveal the radiological characteristics of IPT-like FDCS by radiologic-pathologic correlation. Results We analyzed two cases of IPT-like FDCS in the liver, nine in the spleen, and two in both the liver and spleen concomitantly. IPT-like FDCS presented as well-defined iso- or hypodense masses on unenhanced computed tomography (CT) images in both the liver and spleen. Hyperintensities on T1-weighted images and hypointensities on T2-weighted images with hypointense rings were characteristic features in splenic cases. “Halo signs” were observed in two out of three liver tumors. Hepatic lesions showed significant enhancement, whereas splenic lesions showed only mild enhancement. Delayed annular enhancement was observed in both liver and spleen cases. On ultrasonographic examination, IPT-like FDCS presented as hypoechoic lesions with enhancement similar to that observed on CT. Hyaline fibrous pseudocapsules, which correlated with the hypointensities on T2-weighted images, were microscopically observed at the tumor edge. IPT-like FDCS was characterized by an abundance of small blood vessels and capillaries. Capillaries were also found in the fibrous capsule of some IPT-like FDCSs, which may explain the delayed annular enhancement. Conclusions The manifestations of IPT-like FDCS in the liver and spleen showed differences that warrant them to be approached differently during diagnosis. Characteristic radiological findings of IPT-like FDCS included different enhancement patterns between liver and spleen tumors and rim-like hypointensities on T2-weighted images, as well as annular enhancement on CT and magnetic resonance images. These imaging features correlated with tumor pathology.


2020 ◽  
Author(s):  
Min Zhao ◽  
Xiaohua Du ◽  
Bowen OuYang ◽  
Mingxian Li ◽  
Haifeng Yang

Abstract BACKGROUND: Follicular dendritic cell (FDC) sarcoma is a neoplastic proliferation of spindled to ovoid cells showing morphological and immunophenotypic features of FDCs. Inflammatory pseudotumor-like follicular dendritic cell sarcoma(IPT-FDCS)involves almost exclusively in the liver and spleen and are consistently associated with Epstein-Barr virus (EBV).Rarely, it selectively involves the gastrointestinal tract in the form of a polypoid lesion.CASE SUMMARY: We report two cases of IPT-FDCS mimicking a colonic polyp that received high frequency electrocoagulation separately.The patients’main concern were whether to have chemotherapy or radiation after removal.After many consultations and literature review,The patients were treated by surgical resection, without adjuvant chemotherapy or radiation. Follow-up for 32 months showed no recurrence or metastasis.RESULTS: The neoplasms usually had well—defined borders,composed of the neoplastic spindled cells are dispersed within a prominent lymphoplasmacytic infiltrate. The nuclei usually show a vesicular chromatin pattern and small but distinct nucleoli. Immunohistochemically,tumor cells showed the expression of at least one of the FDC markers,including CD21,CD35, CD23 and D2-40,with scattered positive EBER in situ hybridization.CONCLUSION: IPT-FDCS could rarelly occur in the intestine with a polypoid appearance. Recognization of this disease could avoid being misdiagnosed as other common types of colonic polyposis. EBV-encoded mRNA (EBER) by in situ hybridization and FDC-related immunohistochemical markers plays an important role in differential diagnosis.


2021 ◽  
Author(s):  
Jia Li ◽  
Wenyang Zhou ◽  
Ying Lv ◽  
Rong Hu

Abstract Background: Follicular Dendritic Cell Sarcoma (FDCS) is a rare malignant tumor originated from follicular dendritic cells. Presently radical resection is the standard treatment; however there is no clear optimal chemotherapy for unresectable lesions. We presented the clinical data, pathological features, imaging features, diagnosis and treatment of a very rare patient with recurrence and metastasis after radical resection of pancreatic FDCS. Case presentation: A 64-year-old male patient was delivered to hospital due to intermittent chest tightness and pain. A pancreatic mass was found after thorough physical examination. Enhanced MRI showed a round solid mass in the head and neck of pancreas. The patient underwent radical resection. The pathological diagnosis was FDCS. CHP regimen was used for consolidation chemotherapy for 6 cycles. Two years later, due to a large amount of effusion, the patient was confirmed to have relapse and extensive abdominal metastasis. Both CHOP regimen and bendamustine were ineffective.Conclusions: FDCS of pancreas is very rare, and its imaging findings are not specific. If the disease relapses or metastases, though applies a variety of chemotherapy regimens, it is difficult to obtain satisfactory curative effect, and long-term prognosis is pessimistic. This is the first reported case that bendamustine was ineffective in the treatment of FDCS.


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