目的:探讨临床病理特征,免疫表型,鉴别诊断,扁桃体滤泡树突状细胞肉瘤(FDCS)的预后。
方法:在病理科,青岛大学附属烟台玉皇顶医院,2019年诊断1例扁桃体FDCS,对其临床及病理特点进行回顾性分析.回顾了相关文献。
结果:患者为71岁男性。肿瘤发生于右侧扁桃体,最大直径3.5cm。微观上,肿瘤细胞呈梭形或椭圆形,排列成束或漩涡,一些区域在血管周围形成同心圆。小淋巴细胞分布在背景中。细胞核呈椭圆形或圆形,有核染色质和小的中央核仁。有丝分裂最高可达5/10HPF。免疫组化显示CD21、CD23、CD68、波形蛋白、和肿瘤细胞中的D2-40,Ki67增殖指数约为20%。CXCL13仅在零散的背景淋巴细胞中呈阳性。EBER原位杂交为阴性。手术切除肿瘤后,没有放疗或化疗,到目前为止,患者已经随访了4个月,无复发或转移。
结论:FDCS是一种罕见的肿瘤,尤其是在结外部位。发病机制,FDCS的治疗和预后仍需进一步探索。
OBJECTIVE: To explore the clinicopathologic features, immunophenotype, differential diagnosis, and prognosis of
tonsil follicular dendritic cell sarcoma (FDCS).
METHODS: In the Department of Pathology, the affiliated Yantai Yuhuangding Hospital of Qingdao University, in 2019, a case of
tonsil FDCS was diagnosed and retrospectively analyzed to summarize its clinical and pathologic characteristics. Relevant literature was reviewed.
RESULTS: The patient was a 71-year-old man. The tumor occurred in the right
tonsil with a maximum diameter of 3.5 cm. Microscopically, the tumor cells were spindle-shaped or oval-shaped, arranged in bundles or swirls, and some areas formed concentric circles around blood vessels. Small lymphocytes were distributed in the background. The nucleus was oval-shaped or round, with nuclear chromatin and small central nucleoli. Mitoses were up to 5/10 HPF at the highest. Immunohistochemistry showed positive expression of CD21, CD23, CD68, vimentin, and D2-40 in tumor cells, and Ki67 proliferation index was about 20%. CXCL13 was positive only in scattered background lymphocytes. In situ hybridization for EBER was negative. After surgical resection of the tumor, without radiotherapy or chemotherapy, the patient has been followed up for 4 months until now, without recurrence or metastasis.
CONCLUSIONS: FDCS is a rare tumor, especially in extranodal sites. The pathogenesis, treatment and prognosis of FDCS still need further exploration.