Follicular dendritic cell sarcoma of the breast

Abstract

Extranodal follicular dendritic cell sarcoma (FDCS) is an extremely uncommon tumor with only a single case arising in the breast having been reported. We describe the clinico-pathological features of an additional FDCS of the lower outer quadrant of the right breast in a 40-year-old woman. The tumor showed three patterns of growth, i.e., diffuse, myxoid and fascicular. The neoplastic cells were large, polygonal, with a slightly eosinophilic cytoplasm and oval or convoluted nuclei. They were intermingled with small lymphocytes, plasma cells and a few bizarre multinucleated giant cells. In the fascicular areas, the cells were spindled, while in the myxoid areas they showed a dendritic-like appearance, with long cytoplasmic processes. Mitoses were numerous and often atypical. The neoplastic cells were intensely immunoreactive for CD21, S-100 protein and epithelial membrane antigen, and focally for CD35, CD68 and cytokeratins. Polymerase chain reaction analysis did not reveal any Epstein Barr virus genome in the neoplastic tissue. Electron microscopy highlighted numerous interdigitating cytoplasmic processes with intercellular junctions of the serrated, immature desmosomal or undifferentiated types. The post-surgical course of the patient was uneventful and she is currently free of disease 19 months after surgery.

Interdigitating dendritic cell tumor with breast and cervical lymph-node involvement: a case report and review of the literature

“…The spindle cell or metaplastic carcinoma may be excluded by considering the cytological characteristics of the tumor cells, the lack of any intraductal carcinoma or heterologue components and by the use of immunohistochemical studies. Unlike IDCT, the cells of carcinoma react with cytokeratin [27].…”

“…Normal interdigitating reticulum cells present adenosine triphosphate activity, which was also demonstrated in most of the IDCT cases [4,6,8,30,31,38]. Immunoreactivity for fascin, an actin-bundling protein expressed by follicular and IDC, has been recently proposed as an additional marker of IDCT [11,17,27]. The Ki-67 labeling index usually ranges between 10% and 20% [6].…”

“…There are two reported cases of follicular dendritic cell tumor (FDCT) in the breast [7,27]. The distinction of FDCTs from IDCT is of clinical importance given the reported aggressive behavior of subsets of IDCTs.…”

Dendritic cell sarcomas/tumours of the breast: report of two cases

“…To the best of our knowledge, only two well-documented cases of FDCSs [7,8] of the breast have been reported in the English literature (Table 1). Consistent with the previous cases, the current case showed same features and in addition a lymphocytic lobulitis was present.…”

“…Two of such cases have been previously reported in the breast (Table 1) [7,8]. Extranodal IDCS/Ts have been reported to occur in nasopharynx, small intestine and mesentery, liver, testis, skin, tonsil, spleen, bone marrow, chest wall, paraspinal area, bladder and salivary gland [9,10].…”