Inflammatory pseudotumor‐like follicular dendritic cell sarcoma of the spleen: A report of six cases with increased <scp>IgG4</scp>‐positive plasma cells

Choe, Ji Young; Go, Heounjeong; Jeon, Yoon Kyung; Yun, Ji Yun; Kim, Young A; Kim, Hyun Jung; Huh, Jooryung; Lee, Hojung; Shin, Dong Hoon; Kim, Ji Eun

doi:10.1111/pin.12057

Cited by 75 publications

(74 citation statements)

References 27 publications

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“…Using molecular methods, other genetic alterations have been described, as in ROS1, RET, and NTRK3, which account for part of ALK-negative IMT cases [33,34]. Smooth muscle actin (SMA) is by no means marker for IMT, as its expression may be seen in other lesions, including FDC tumors [35].…”

Section: Inflammatory Pseudotumor and Inflammatory Myofibroblastic Tumormentioning

confidence: 99%

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Inflammatory pseudotumor-like follicular dendritic cell tumor: an underdiagnosed neoplasia

et al. 2017

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Follicular dendritic cell (FDC) tumor is an uncommon neoplasm. It generally presents as a slow-growing, painless mass, without systemic symptoms. Histological features usually include low grade spindle cell proliferation. This tumor occurs primarily in lymph nodes, especially cervical and axillary, however, involvement of extranodal sites such as the tonsils, spleen, liver, and gastrointestinal tract has been reported. Inflammatory pseudotumor-like follicular dendritic cell tumor (IPT-like FDCT) is a rare, distinctive histological subtype of this low-grade malignant neoplasm, with consistent Epstein-Barr virus (EBV) association. The differential diagnosis with other fibro-inflammatory tumor proliferations, as inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT), may be challenging. In the present article, two cases of IPT-like FDCT of the spleen are presented, with a broad overview of the literature: one 77-year-old male and one 70-year-old female. A large immunohistochemical panel should be used for diagnosis, as no single specific and totally sensitive markers are available, including markers for CD21, CD23, CD35, CNA42, and clusterin. Individual cases may express one or more of these markers, so that all of them should be investigated. In situ hybridization for EBV is constantly positive. Immunostaining for ALK should be negative, as it is present in roughly half of the cases of IMT. This panel should be used in combination of clinical, laboratory, and topographic evidences. Importantly, inclusion of this lesion as a possible option in clinical and pathological investigation represents the basis for a correct diagnosis.

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Section: Inflammatory Pseudotumor and Inflammatory Myofibroblastic Tumormentioning

confidence: 99%

“…From 1996 to date we retrieved 22 publications reporting IPT-like FDC tumors [11,15,35,[89][90][91][92][93][94][95][96][97][98][99][100][101][102][103][104][105][106][107]. There were 46 patients described: 24 female, 22 male (ratio 1.1:1), median age 57y (range 29-79y).…”

Section: Follicular Dendritic Cell Tumors Of the Spleenmentioning

confidence: 99%

Inflammatory pseudotumor-like follicular dendritic cell tumor: an underdiagnosed neoplasia

et al. 2017

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“…To our knowledge, there were several reports about the possibility of splenic involvement in IgG4-RD [4][5][6][7] . These reports indicated that sclerosing angiomatoid nodular transformation (SANT), as inflammatory pseudotumor, with increased numbers of IgG4+ plasma cells in spleen might be cases of IgG4-related sclerosing lesions of the spleen [4][5][6] .…”

Section: Discussionmentioning

confidence: 99%

“…These reports indicated that sclerosing angiomatoid nodular transformation (SANT), as inflammatory pseudotumor, with increased numbers of IgG4+ plasma cells in spleen might be cases of IgG4-related sclerosing lesions of the spleen [4][5][6] . One report showed that inflammatory pseudotumor-like follicular dendritic cell sarcoma of the spleen with increased IgG4-positive plasma cells might be one of possible IgG4-RD [7] . In the present study, sarcoidosis and lymphoma were excluded by both laboratory (normal angiotensin converting enzyme and lysozyme levels) and pathological examinations.…”

Section: Discussionmentioning

confidence: 99%

Splenic lesion of IgG4-related disease in FDG-PET/CT

Taniguchi

Ogata

Shimamura

et al. 2014

CRIM

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Recent several reports showed that 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) scans accurately, and safely identifies the multiple organs' involvements in IgG4-related diseases (IgG4-RD) patients. Disease activity in two patients, aged 74 and 73 years (serum IgG4, 807 and 1630 mg/dl, respectively), with IgG4-RD were monitored using FDG-PET/CT. Scans before treatment showed splenomegaly with high FDG uptake. Inflammatory aneurysm, submandibular gland swelling, splenomegaly and tubulointerstitial nephritis resolved after treatment with prednisolone. Follow-up FDG-PET/CT at 4 months, with no symptoms, showed a significant decrease in FDG accumulation and improvement of splenomegaly in splenic lesion of IgG4-RD. Thus, splenic lesions detected by FDG-PET/CT might be novel involvements of IgG4-RD.

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“…Takahashi et al further reported patients with IgG4-RD may be at an increased risk of developing non-Hodgkin lymphoma [3]. Significant numbers of IgG4+ plasma cells were found within inflammatory pseudotumor-like follicular dendritic cell sarcoma [4]. Recently we also reported a case of IgG4-RD who was diagnosed as small B cell lymphoma, received chemotherapy and autologous stem cell transplantation 10 years ago and eventually developed diffuse large Bcell lymphoma two years after the diagnosis of IgG4-RD (unpublished data).…”

Section: Introductionmentioning

confidence: 99%

The Expression of IgG and IgG4 in Lymphoma

Li¹,

Zhang²

2014

Intern Med

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Objectives: Although IgG4-related disease has been gradually recognized, its relationship with malignant diseases, especially lymphoma has been an eternal topic. Therefore we set out to explore the expression of IgG4 positive cells in lymphoma.Methods: Surgical excision specimens with definite diagnosis of lymphoma from January to December, 2013 were collected. Hematoxylin-eosin staining and immunohistochemical staining of IgG and IgG4 were then evaluated on dense lymphoplasmacytic infiltration, storiform fibrosis and obliterative phlebitis. For the quantification of IgG and IgG4 positive cells, the areas with the highest density of positive cells were evaluated. Three high-powered fields (hpf) in each section were analyzed, and the average number of positive cells per hpf was calculated.Results: 16 patients with lymphoma were included in our study. There were 9 males and 7 females with an average age of 51 years old. 3 cases were diagnosed as Hodgkin lymphoma while 13 were non-Hodgkin lymphoma (diffuse large B cell lymphoma 8 cases, small B cell lymphoma 2 cases, mucosa associated lymphoid tissue marginal zone B cell lymphoma (MALToma) 1 case, follicular lymphoma, peripheral T-cell lymphoma and hepatosplenic T-cell lymphoma 1 case. Dense lymphocytic infiltration accompanied by atypical lymphocytes was observed in all the specimens. Proliferation of fibrous tissue was only seen in one specimen. IgG positive cells were detectable in 14 cases with the highest cell count from 20-350/hpf. 2 Hodgkin lymphoma cases showed of IgG4 positivity with the highest cell counts were 11 and 12/hpf respectively. Conclusion:IgG4 positive cells, fibrosis and obliterative phlebitis barely appeared in lymphoma. In combination with specific tumor signature molecules, it may not be difficult to distinguish lymphoma from IgG4-related disease.

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Inflammatory pseudotumor‐like follicular dendritic cell sarcoma of the spleen: A report of six cases with increased IgG4‐positive plasma cells

Cited by 75 publications

References 27 publications

Inflammatory pseudotumor-like follicular dendritic cell tumor: an underdiagnosed neoplasia

Inflammatory pseudotumor-like follicular dendritic cell tumor: an underdiagnosed neoplasia

Splenic lesion of IgG4-related disease in FDG-PET/CT

The Expression of IgG and IgG4 in Lymphoma

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