Follicular Dendritic Cell Sarcoma of the Inflammatory Pseudotumor-like Variant Presenting as a Colonic Polyp
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Follicular dendritic cell (FDC) sarcoma is rare and is classified either as conventional type or inflammatory pseudotumor (IPT)-like variant. Extranodal presentation is uncommon and nearly all gastrointestinal FDC tumors are of the conventional type. IPT-like variant tumors occur almost exclusively in the liver and spleen and are consistently associated with Epstein-Barr virus (EBV). Here we report the case of a 78-year-old woman with an IPT-like FDC sarcoma presenting as a pedunculated colonic polyp. Histologically, scanty atypical ovoid to spindle cells were mixed with a background of florid lymphoplasmacytic infiltrate, which led to an initial misdiagnosis of pseudolymphoma. These atypical cells expressed CD21, CD23, CD35, and D2-40, and were positive for EBV by in situ hybridization, confirming the diagnosis. The patient was free of disease five months after polypectomy without adjuvant therapy. Although extremely rare, the differential diagnosis for colonic polyp should include FDC sarcoma to avoid an erroneous diagnosis. A review of the 24 cases of IPT-like FDC sarcoma reported in the literature reveal that this tumor occurs predominantly in females with a predilection for liver and spleen, and has a strong association with EBV.
Abstract
Follicular dendritic cell (FDC) sarcoma is rare and is classified either as conventional type or inflammatory pseudotumor (IPT)-like variant. Extranodal presentation is uncommon and nearly all gastrointestinal FDC tumors are of the conventional type. IPT-like variant tumors occur almost exclusively in the liver and spleen and are consistently associated with Epstein-Barr virus (EBV). Here we report the case of a 78-year-old woman with an IPT-like FDC sarcoma presenting as a pedunculated colonic polyp. Histologically, scanty atypical ovoid to spindle cells were mixed with a background of florid lymphoplasmacytic infiltrate, which led to an initial misdiagnosis of pseudolymphoma. These atypical cells expressed CD21, CD23, CD35, and D2-40, and were positive for EBV by in situ hybridization, confirming the diagnosis. The patient was free of disease five months after polypectomy without adjuvant therapy. Although extremely rare, the differential diagnosis for colonic polyp should include FDC sarcoma to avoid an erroneous diagnosis. A review of the 24 cases of IPT-like FDC sarcoma reported in the literature reveal that this tumor occurs predominantly in females with a predilection for liver and spleen, and has a strong association with EBV.
참고문헌 (23)
- Monda L, "A primary lymph node malignancy with features suggestive of dendritic reticulum cell differentiation: a report of 4 cases", Am J Pathol, 122, pp.562~572 (1986)
- Chan JK, "WHO classification of tumours of haemtopoietic and lymphoid tissues", pp.363~364 (2008), IARC Press
- Cheuk W, "Inflammatory pseudotumor-like follicular dendritic cell tumor: a distinctive low-grade malignant intra-abdominal neoplasm with consistent Epstein-Barr virus association", Am J Surg Pathol, 25, pp.721~731 (2001)
- Shia J, "Extranodal follicular dendritic cell sarcoma: clinical, pathologic, and histogenetic characteristics of an underrecognized disease entity", Virchows Arch, 449, pp.148~158 (2006)
- Li L, "Clinicopathological features and prognosis assessment of extranodal follicular dendritic cell sarcoma", World J Gastroenterol, 16, pp.2504~2519 (2010)
- Agaimy A, "Follicular dendritic cell tumor of the gastrointestinal tract: report of a rare neoplasm and literature review", Pathol Res Pract, 202, pp.541~548 (2006)
- Arber DA, "Frequent presence of the Epstein-Barr virus in inflammatory pseudotumor", Hum Pathol, 26, pp.1093~1098 (1995)
- Selves J, "Inflammatory pseudotumor of the liver: evidence for follicular dendritic reticulum cell proliferation associated with clonal Epstein-Barr virus", Am J Surg Pathol, 20, pp.747~753 (1996)
- Shek TW, "Follicular dendritic cell tumor of the liver: evidence for an Epstein-Barr virus-related clonal proliferation of follicular dendritic cells", Am J Surg Pathol, 20, pp.313~324 (1996)
- Shek TW, "Intra-abdominal follicular dendritic cell tumour: a rare tumour in need of recognition", Histopathology, 33, pp.465~470 (1998)
- Chen TC, "Follicular dendritic cell tumor of the liver: a clinicopathologic and Epstein-Barr virus study of two cases", Mod Pathol, 14, pp.354~360 (2001)
- Brittig F, "Follicular dendritic reticulum cell tumor mimicking inflammatory pseudotumor of the spleen", Pathol Oncol Res, 10, pp.57~60 (2004)
- Horiguchi H, "Inflammatory pseudotumor-like follicular dendritic cell tumor of the spleen", Pathol Int, 54, pp.124~131 (2004)
- Bai LY, "Follicular dendritic cell tumor of the liver associated with Epstein-Barr virus", Jpn J Clin Oncol, 36, pp.249~253 (2006)
- Laurent C, "Follicular dendritic cell tumor of the spleen associated with diffuse large B-cell lymphoma", Hum Pathol, 39, pp.776~780 (2008)
- Granados R, "Cytopathology of a primary follicular dendritic cell sarcoma of the liver of the inflammatory pseudotumor-like type", Diagn Cytopathol, 36, pp.42~46 (2008)
- Chan JK, "Follicular dendritic cell tumors of the oral cavity", Am J Surg Pathol, 18, pp.148~157 (1994)
- Chan JK, "Follicular dendritic cell sarcoma: clinicopathologic analysis of 17 cases suggesting a malignant potential higher than currently recognized", Cancer, 79, pp.294~313 (1997)
- Teruya-Feldstein J, "The role of Mig, the monokine induced by interferon-gamma, and IP-10, the interferon-gamma-inducible protein-10, in tissue necrosis and vascular damage associated with Epstein-Barr virus-positive lymphoproliferative disease", Blood, 90, pp.4099~4105 (1997)
- Li Z, "Extranodal follicular dendritic cell sarcoma in mesentery: a case report", Oncol Lett, 2, pp.649~652 (2011)
- Miettinen M, "WHO classification of tumours of the digestive system", pp.241~250 (2010), IARC Press
- Pantanowitz L, "Inflammatory fibroid polyps of the gastrointestinal tract: evidence for a dendritic cell origin", Am J Surg Pathol, 28, pp.107~114 (2004)
- Makhlouf HR, "Inflammatory myofibroblastic tumors (inflammatory pseudotumors) of the gastrointestinal tract: how closely are they related to inflammatory fibroid polyps?", Hum Pathol, 33, pp.307~315 (2002)