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Indeterminate Dendritic Cell Tumor in Thoracic Spine: A Case Report
Sze Kiat Tan1, Lee Onn Chieng1, Karthik Madhavan1
1Department of Neurological Surgery and the Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida, USA.
World Neurosurgery
|July 31, 2017
Summary
Indeterminate dendritic cell tumor (IDCT), an extremely rare hematologic disorder, presented unusually as a spinal mass. This case highlights the first reported instance of spinal IDCT, emphasizing the need for diagnostic awareness.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Indeterminate dendritic cell tumor (IDCT) is a rare hematologic neoplasm with unknown origins.
- Unusual presentations of IDCT, particularly in the spine, are not well-documented in medical literature.
Observation:
- A 51-year-old male presented with progressive thoracic back pain and a T9 vertebral mass causing spinal stenosis.
- Initial biopsy suggested histiocytic sarcoma, but further analysis was required.
Findings:
- Surgical resection revealed the mass to be IDCT with fibrosis.
- Immunohistochemistry showed partial positivity for Langerhans cell markers (S100, CD1a) and blastic plasmacytoid dendritic cell neoplasm markers, alongside CD45, CD68, and CD163.
- The tumor lacked Birbeck granules and Langerin, complicating definitive classification.
Implications:
- This case represents the first documented instance of IDCT affecting the spine.
- Accurate diagnosis of IDCT requires familiarity with its unique and sometimes ambiguous immunophenotype.
- Further research into IDCT pathogenesis and classification is warranted due to its indeterminate cell of origin.
