滤泡树突状细胞肉瘤5例临床病理分析

Follicular dendritic cell sarcoma:a clinicopathologic analysis of five cases

目的探讨滤泡树突细胞肉瘤的临床病理学特征、诊断及鉴别诊断,提高对该肿瘤的认识和诊断水平。方法对5例滤泡树突状细胞肉瘤进行光镜观察和免疫组化标记,并复习文献加以分析。结果瘤细胞梭形或卵圆形,常呈巢状、旋涡状和席纹状排列,细胞边界不清,呈合体状,核圆形或卵圆形,核膜清晰,染色质点彩状或空泡状,有小核仁。瘤细胞间常混有大量小淋巴细胞。免疫表型:瘤细胞CD21、CD23、CD35阳性。结论滤泡树突状细胞肉瘤是一种罕见的恶性肿瘤,诊断较困难,正确的诊断及鉴别诊断须依赖于免疫组化。

Objective To study the clinical and pathological characteristics, diagnosis and differential diagnosis of follicular dendritic cell sarcoma and to improve awareness and diagnosis level of the tumor. Methods Five cases of follicular dendritic cell sarcoma were investigated by light microscopy and immunohistochemical staining with review of the related literature. Results Microscopically, the tumors were composed of spindle to oval cells arranged in nests, whorls and storiform patterns. The neoplastic cells were characterized by delicate nuclear membrane, vesicular or stippled chromatin, small but distinct nucleoli. Small lymphocytes were scattered throughout the tumor. Immunohistochemically, neoplastic cells were immunoreactive for CD21, CD23 and CD35. Conclusion Follicular dendritic cell sarcoma is a rare malignant tumor. A correct diagnosis can be difficult to make sometimes, and immunohistochemical and ultrastructural studies are necessary for its diagnosis and differential diagnosis.