腮腺滤泡性树突状细胞肉瘤1例及文献复习

目的探讨滤泡性树突状细胞肉瘤的病理诊断及鉴别诊断。方法对1例腮腺滤泡性树突状细胞肉瘤进行HE切片、免疫组化等观察,并复习文献进行讨论。结果镜检肿瘤细胞呈梭形、卵圆形、多边形,胞质淡染,边界不清,核染色质颗粒状并见明显小核仁,可见散在核分裂象,呈片状、束状、编织状、旋涡状排列。较多淋巴细胞浸润及围绕血管形成袖套状结构。肿瘤细胞特异性地表达CD21、CD23、CD35、S-100蛋白、CD68、vim entin、EMA。结论滤泡性树突状细胞肉瘤是极少见的低中度恶性肿瘤,可出现多种组织结构,有一定的特征性,确诊需要免疫组化帮助。应与异位脑膜瘤、异位胸腺瘤、恶性纤维组织细胞瘤、淋巴上皮样癌及指突性树突状细胞肿瘤等相鉴别。

Follicular dendritic cell sarcoma of parotid: a case report and review of literatures

Purpose To study pathologic diagnosis and differential diagnosis of follicular dendritic cell sarcoma.Methods A case of follicular dendritic cell sarcoma of the parotid was investigated by hematoxylin-eosin and immunohistochemical staining.Results Microscopically,the neoplastic cells were oval,spindle or polygonal with pale-stained cytoplasm,indistinct cell borders,granular chromatin,distinct small nucleoli,and scattered mitoses could be observed.There were varied growth patterns in the tumor,such as fascicles,storiform,circular whorls,and sheets.Numerous lymphocytes infiltrated with cuffing around blood vessels.The neoplastic cells were immunoreactive for CD21,CD23,CD35,S-100 protein,CD68,vimentin,and epithelial membrane antigen.Conclusions Follicular dendritic cell sarcoma is a rare low-intermediate grade malignancy with varied growth pattern.It is important to recognize its morphological characteristics to avoid confusion with other similar lesions,such as ectopic meningioma,ectopic thymoma,malignant histiocytoma,lymphoepithelioma-like carcinoma and interdigitaing dendritic cell tumor.The diagnosis shall be confirmed by immunohistochemical study.