颈部复发性滤泡树突细胞肉瘤1例并文献复习

Recurrent follicular dendritic cell sarcoma of the neck:a case report and literature review

目的:分析头颈部滤泡树突细胞肉瘤的临床特征、治疗方式和预后。方法:复习1例颈部复发性滤泡树突细胞肉瘤的治疗及随诊资料,结合相关文献探讨其临床特征以及治疗、预后。结果:颈部滤泡树突细胞肉瘤主要表现为无痛性肿块;肿瘤细胞呈纺锤形/卵圆形,呈束状、旋涡状排列;免疫组化CD21和CD35阳性。复发后二次手术挽救加术后放疗,1年后死于肺转移,未见局部复发。结论:颈部滤泡树突细胞肉瘤是一种少见的低到中度恶性肿瘤,需借助免疫组化的方法与其他组织学形态类似的肿瘤鉴别,治疗多数以手术为主,伴有病理不良预后因素、复发或残存时辅助放疗/化疗。

Objective：To analyse the clinical features and treatment,prognosis of follicular dendritic cell sarcoma（FDCS） of the head and neck.Methods： To review the treatment and follow-up data of a recurrent FDC sarcoma patient in the neck and investigate the clinical features,optimal treatment,and prognosis with pertinent literatures.Results： The most common complaint of FDCS in the head and neck region is an asymptomatic enlarging neck mass.Microscopically,the tumor cells were spindly or ovoid in shape and arranged in fascicular,whorled pattern.Immunohistochemically,the tumor cells were strongly positive for both CD21 and CD35.The patient was treated with surgical excision and postoperative irradiation.He died from lung metastasis one year after completing salvage treatment for recurrent FDCS and without any evidence of local recurrence.Conclusion： Follicular dendritic cell sarcoma is a rare neoplasm of low to intermediate malignant potential.Diagnosis requires immunohistochemical evaluation to distinguish from other malignance of similar histological pattern.The primary treatment is wide local surgical resection.Adjuvant radiotherapy or chemotherapy appears to be indicated in cases having adverse pathologic features and in recurrent or incompletely resected lesions.