Lymph Node Interdigitating Cell Sarcoma: A Case Report

Abstract

A 54-year-old man was admitted because of right supraclavicular lymphadenopathy of some weeks duration. Computed axial tomography revealed a large multinodular lesion in a supraclavicular lymph node. The patient then had a supraclavicular lymph node biopsy. Light microscopy showed a tumor whose structure was suggestive of an interdigitating cell sarcoma. Enzyme and immunohistochemical analysis showed that the tumor cells possessed membranous adenosine triphosphatase activity, intracytoplasmic S100 protein, surface CD1a and CD4 antigens, and HLA-DR antigen. Ultrastructural examination showed that the cells exhibited many interdigitating cytoplasmic extensions, but no Birbeck granules. DNA content analysis of the tumor cells proved that the cells were malignant. These data are consistent with derivation from a lymph node interdigitating cell.

Dendritic cell neoplasms: An overview

“…Significant immunophenotypic overlap exists between IDDCT/S and FDCT/S. Markers that can distinguish the two entities include R4/23, CD21, CD35 [29][30][31], and 5 0 nucleotidase activity, which are positive in FDCT/S. On the other hand, ATPase activity [32], S-100 [30,33], and HLA-DR [33,34] positivity are present in IDDCT/S.…”

“…Presence of CD1a in LCT/S helps differentiating it from both IDDCT/S and FDCT/S [35]. In IDDCT/S, T-cell rearrangement has not been identified [36] and the Langerhans' exclusive Birbeck granules are not observed [29][30][31]33,34]. In short, the criteria for diagnosing IDDCT/S include appropriate morphology, paracortical location of the process in the lymph node, strong S-100 positivity, and the lack of CD1a as well as FDCT/S markers.…”

“…The tumor cell has also been described as ovoid or polygonal [27], and it can be mono-, bi-, or multinucleated [30,37]. Even though FDCT/S consists of a pleomorphic cell population, it most invariably displays the characteristic spindle shaped cell [27] with an irregular nucleus [20,31,38]. The nucleus can exhibit one of various shapes: indented [32,33], walnut, cerebriform, bean-shaped [30], ovoid [39][40][41], and poly lobated [42].…”

“…Positivity for Ki67 [47,51], CNA 42 [37,52], DRC-1 [27], smooth muscle actin [45], and CD74 [34] has also been observed. The random positivity for CD45 RB or LCA has blurred the certainty of the origin of FDCT/S [25,31]. Even though the cell possesses the Epstein-Barr virus (EBV) receptor, CD21, most reported cases did not test positive for the virus antigens, suggesting the absence of EBV transformed FDC lines [53].…”

“…The clinical presentation varies according to the location of the primary tumor. Nodal tissue involvement occurs in the hilar [37], mediastinal [27,47,59], para-aortic [47], and mesenteric areas [27], but with a greater tendency in cervical, axillary, and supraclavicular nodes [25,27,[29][30][31]36,37,42,48,49,60,61]. FDCT/ S has also been described in other lymphoid tissues including the tonsils [25, 27,29,[61][62][63], nasopharynx [39], paraphrynx [61], and the spleen [27,29].…”