Reticulum Cell Sarcoma of Lymph Node with Mixed Dendritic and Fibroblastic Features

Abstract

We report a case of clinically aggressive reticulum cell sarcoma with mixed follicular dendritic cell (FDC) and fibroblastic reticular cell (FRC) features. Histologically, the tumor was confined to lymph nodes occurring as a multifocal epithelioid and spindle cell proliferation with appreciable mitotic rate and numerous admixed non-neoplastic B-cells. IDCs have a primary function in antigen presentation in the interfollicular zones of the node and differentiate from Langerhans cells migrating from skin or from bone marrow-derived precursors (2). FRCs form a diffuse extrafollicular network that guides cell migration within the lymph node (7). Nodal sarcomas have been described that are postulated to arise from each of these different reticular cell populations. These include CD21-and CD35-positive FDC sarcoma (8) and S100-positive IDC sarcoma (9 -12). Recently, several groups have reported nodal sarcomas of possible FRC lineage (13-15). However, some of these tumors have been incompletely studied, with only limited antigen profiling and ultrastructural analysis. Thus, the range of features associated with FRC sarcoma is not yet clearly delineated. Here, we report the first morphologic, extended phenotypic and genotypic characterization of a case of primary lymph node sarcoma with mixed dendritic and fibroblastic features. METHODSHematoxylin and eosin-stained histologic sections from the original biopsy specimen obtained at an outside hospital were compared with the initial resection and tumor recurrence specimens, both done at our institution. Clinical information was obtained from the medical record.

Follicular Dendritic Cell Sarcoma: Cytogenetics and pathological findings

“…3 Add(21q), add(21p), add(15p) and add(17p) were reported by Suzuki et al, Perry et al and Jones et al 2,3,5 The patient in the current report study also had add(19q) and did not have any involvement of chromosomes 14, 15, 17 or 21. Marker chromosomes were seen in two earlier cases reported by Perry et al, which were also observed in the patient in the current report in all of the abnormal metaphases.…”

“…6 However, in another report of FDCS by Jones et al, all these markers were negative. 5 The current patient had hypertriploidy in all of the abnormal metaphases ranging from 72 to 80. Earlier reports of FDCS have shown hypodiploidy and diploidy in two cases; 3,7 furthermore, two cases had hyperdiploidy along with pseudodiploidy.…”

“…5,7 Della Porta et al reported a patient with hypotriploidy and Jones et al reported a patient with hypertetraploidy. 5,9 Notably, two reported cases showed the involvement of chromosome Xp. 5,7 No involvement of chromosome X was observed in the current patient.…”

“…Thus far, only six case reports are available in the literature with chromosomal findings. 2,[3][4][5][6][7] To the best of the authors' knowledge, this is the first report from a Middle Eastern Arab population. The results of the current case yielded a good mitotic index and morphology of chromosomes by culturing the FNA of the tumour, which is often difficult to obtain.…”

A Rare Case of Cytokeratin-Positive Interstitial Reticulum Cell Sarcoma and Review of the Entity

“…Other than pure FBRCTs or CIRCTs Jones et al [10] reported a case of reticulum cell sarcoma with mixed dendritic and fibroblastic features, Kakiuchi et al [11] described a case of CIRCT with Castleman's disease and Suárez et al [12] found a case of CIRCT coincidentally with an undifferentiated endometrial stromal sarcoma.…”