Parapharyngeal lymph node as an isolated manifestation of follicular dendritic cell sarcoma: First report in Iran

Follicular dendritic cell sarcoma (FDCS) is a rare type of sarcoma that originates from the stromal component of the germinal center of the B-follicle. Its presentation and prognosis vary, as it can be nodal or extranodal, localized or multifocal, and can be fatal in 20% of cases. Due to its rarity, FDCS diagnosis requires a high level of suspicion. Most cases have been reported in Europe or the United States, and no cases have been previously reported in individuals of Iranian descent. This case report describes a 33-year-old Iranian man with no significant medical history who presented with a palpable nodule in the neck and odynophagia. Magnetic resonance imaging revealed a mass with heterogeneous enhancement in the parapharyngeal space. Pathological examination confirmed FDCS, likely localized to a parapharyngeal lymph node with no extranodal involvement. The patient underwent radiation therapy and remained disease-free 28 months after diagnosis.