Epstein-Barr virus-positive inflammatory follicular dendritic cell sarcoma with significant granuloma: case report and literature review.

Autor: Nie C; Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Jiefang West Road, Changsha, 410000, Hunan Province, China., Xie X; Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Jiefang West Road, Changsha, 410000, Hunan Province, China., Li H; Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Jiefang West Road, Changsha, 410000, Hunan Province, China., Li Y; Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Jiefang West Road, Changsha, 410000, Hunan Province, China., Chen Z; Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Jiefang West Road, Changsha, 410000, Hunan Province, China. zhchen1997@hunnu.edu.cn., Li Y; Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Jiefang West Road, Changsha, 410000, Hunan Province, China., Li Z; Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Jiefang West Road, Changsha, 410000, Hunan Province, China.
Jazyk: angličtina
Zdroj: Diagnostic pathology [Diagn Pathol] 2024 Feb 16; Vol. 19 (1), pp. 34. Date of Electronic Publication: 2024 Feb 16.
DOI: 10.1186/s13000-024-01457-6
Abstrakt: Background: Epstein-Barr virus-positive inflammatory follicular dendritic cell sarcoma (EBV+IFDCS) is a rare disease characterized by mild clinical symptoms and non-specific imaging findings. The diagnosis of the disease depends on pathological diagnosis. However, EBV+IFDCS has a very broad spectrum of histological morphology and immune phenotypes, and its histopathological features have not been fully described by pathologists.
Case Presentation: A 59-year-old female, with no significant discomfort, was found to have a splenic mass during a routine physical examination. Microscopic examination at low magnification revealed numerous epithelioid granulomas, amidst which a substantial inflammatory response was observed. Interspersed among the dense inflammatory cells were spindle or oval-shaped cells, distributed sporadically with indistinct boundaries. Under high magnification, these spindle cells had subtle features: smooth and clear nuclear membranes, inconspicuous small nucleoli, and infrequent mitotic figures. Immunophenotypically, the spindle cells expressed CD21 and CD23, and Epstein-Barr encoding region (EBER) in situ hybridization yielded positive results. The inflammatory milieu predominantly consisted of T cells, with a minority of plasma cells expressing IgG4. The confluence of morphological and immunohistochemical findings led to the final pathological diagnosis of EBV+IFDCS in this case.
Conclusions: The presentation of EBV+IFDCS with pronounced granulomatous changes is rare. This morphological variant poses a high risk of misdiagnosis, frequently leading to confusion with other granulomatous diseases. Accurate diagnosis necessitates a comprehensive analysis, integrating immunohistochemistry and in situ hybridization. The case presented here is instrumental in raising awareness and understanding of EBV+IFDCS, with the goal of reducing misdiagnoses and unrecognized cases.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje