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Cytopathology of follicular dendritic cell tumors
C A Wright1, S J Nayler, G Leiman
1Department of Anatomical Pathology, School of Pathology, South African Institute for Medical Research, Johannesburg, South Africa.
Insights
Follicular dendritic cell tumors (FDCTs) are rare, originating from immune cells in lymph nodes. Diagnosis requires immunohistochemistry (CD21, CD35) and electron microscopy for confirmation.
Area of Science:
- Oncology
- Immunology
- Pathology
Background:
- Follicular dendritic cell tumors (FDCTs) are rare neoplasms originating from antigen-presenting immune accessory cells within B-lymphocyte follicles.
- These tumors can occur in both nodal and extranodal sites, posing diagnostic challenges.
Observation:
- This report details two cases of FDCTs, with one case concurrently diagnosed with Castleman's disease.
- Both cases underwent fine-needle aspiration biopsy followed by surgical biopsy for definitive diagnosis.
Findings:
- Cytologic and histologic findings were analyzed, with diagnosis confirmed by positive immunoreactivity for CD21 and CD35 antibodies.
- Ultrastructural examination revealed characteristic interdigitating cell processes with desmosomes, further supporting the diagnosis of FDCT.
Implications:
- Recognition of FDCTs' distinct pathologic features is crucial for accurate diagnosis.
- Immunohistochemistry (CD21, CD35) and electron microscopy are essential for confirming the diagnosis and differentiating from other neoplasms.
Abstract:
Follicular dendritic cell tumors are rarely described entities, arising from antigen-presenting immune accessory cells, found within B-lymphocyte follicles in nodal and extranodal sites. We report two cases, one associated with Castleman's disease, in whom fine-needle aspiration biopsy was performed followed by surgical biopsy. The diagnosis was confirmed using immunoreactivity with CD21 and CD35 antibodies and by ultrastructural demonstration of interdigitating cell processes with desmosomes. Both the cytologic and histologic findings are presented, and the differential diagnoses are discussed. Awareness of this entity and recognition of the pathologic features may lead to a presumptive diagnosis which must be confirmed using imunohistochemistry and/or electron microscopy.
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