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Case Reports
. 2021 Jan;9(1):77.
doi: 10.21037/atm-20-4965.

A rare case of primary pulmonary inflammatory pseudotumor-like follicular dendritic cell sarcoma successfully treated by lobectomy

Huayu He  1 , Qi Xue  1 , Fengwei Tan  1 , Lin Yang  2 , Xin Wang  2 , Yushun Gao  1 , Yousheng Mao  1 , Juwei Mu  1 , Dali Wang  1 , Jun Zhao  1 , Liang Zhao  1 , Shugeng Gao  1
Affiliations
Case Reports

A rare case of primary pulmonary inflammatory pseudotumor-like follicular dendritic cell sarcoma successfully treated by lobectomy

Huayu He et al. Ann Transl Med. 2021 Jan.

Abstract

Primary pulmonary inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS) is extremely rare. Here, we report a case of a 64-year-old female with primary pulmonary IPT-like FDCS. The patient was found to have a solid nodule in the right lower lobe (RLL) of the lung incidentally without any symptoms or signs of discomfort. The chest computed tomography (CT) showed that there was an irregular nodule in the basal segment of the RLL, approximately 2.0 cm × 1.1 cm × 1.0 cm in size, of 15 HU in CT value. While the result of the fiberoptic bronchoscope-guided biopsy of the mass showed that there was inflammatory cell infiltration, no evidence of malignancy was found. After a thorough discussion of the multidisciplinary team, lobectomy of the RLL and systematic lymph node dissection were performed for the patient. Histologic analysis of the resected mass revealed infiltration of a large number of lymphocytes and plasma cells with the expression of CD21, CD23, CD35 were positive. In addition, the Epstein-Barr virus (EBV) probe in situ hybridization were positive. As a result, the diagnosis of EBV-positive IPT-like FDCS was strongly supported. No recurrence or any signs of metastasis were found during a 10-month follow-up time. As we have reported in this rare case, the diagnosis of primary pulmonary IPT-like FDCS should be considered even when there is only lymphoplasmacytic infiltration and no evidence of malignant tumor cells in the lung.

Keywords: Inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like-FDCS); lobectomy; primary; pulmonary.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-4965). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Chest enhanced computed tomography (CT) examination. The images show an irregular nodule in the basal segment of the RLL that is approximately 2.0 cm × 1.1 cm × 1.0 cm in size, with a low density and a CT value of approximately 15 HU. The lesions were not enhanced after enhancement. (A) Pulmonary window; (B) mediastinal window; (C) coronal image; (D) sagittal image. The arrows indicate the lesions.
Figure 2
Figure 2
Composite H&E staining: a large number of lymphoplasmacytic cells, accompanied by the proliferation of spindle cells. Original magnification: (A) ×100; (B) ×400.
Figure 3
Figure 3
Follicular dendritic cell (FDC) marker. Immunohistochemistry staining, the Benchmark XT stainer. (A) CD21, strongly positive (×100); (B) CD23, strongly positive (×100); (C) CD35, strongly positive (×100); (D) CD163, strongly positive (×100); (E) Ki-67, 30% (×100); (F) the EBV-coded RNA (EBER) was strongly positive by Chromogenic in situ hybridization (CISH) (×400).
See this image and copyright information in PMC

References

    1. Li L, Shi YH, Guo ZJ, et al. Clinicopathological features and prognosis assessment of extranodal follicular dendritic cell sarcoma. World J Gastroenterol 2010;16:2504-19. 10.3748/wjg.v16.i20.2504 - DOI - PMC - PubMed
    1. Cheuk W, Chan JK, Shek TW, et al. 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 2001;25:721-31. 10.1097/00000478-200106000-00003 - DOI - PubMed
    1. Mograbi M, Stump MS, Luyimbazi DT, et al. Pancreatic inflammatory pseudotumor-like follicular dendritic cell tumor. Case Rep Pathol 2019;2019:2648123. 10.1155/2019/2648123 - DOI - PMC - PubMed
    1. Saygin C, Uzunaslan D, Ozguroglu M, et al. Dendritic cell sarcoma: a pooled analysis including 462 cases with presentation of our case series. Crit Rev Oncol Hematol 2013;88:253-71. 10.1016/j.critrevonc.2013.05.006 - DOI - PubMed
    1. Shia J, Chen W, Tang LH, et al. Extranodal follicular dendritic cell sarcoma: clinical, pathologic, and histogenetic characteristics of an underrecognized disease entity. Virchows Arch 2006;449:148-58. 10.1007/s00428-006-0231-4 - DOI - PubMed

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