Shunsuke Koga, Du Wei, Gabriel C Caponetti, Kumarasen Cooper
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Follicular Dendritic Cell Sarcoma of the Parapharyngeal Space Arising in Association With Castleman Disease.
Follicular dendritic cell sarcoma (FDCS) is a rare malignant neoplasm of follicular dendritic cell origin. It is occasionally associated with unicentric Castleman disease (UCD), particularly the hyaline-vascular (HV) variant (HV-UCD). We report a 56-year-old woman with FDCS arising in the parapharyngeal space in the background of HV-UCD. The patient presented with a painless right neck mass and extensive cervical lymphadenopathy without systemic symptoms. Surgical resection of the parapharyngeal mass revealed FDCS in the lymph nodes with features of HV-UCD. Immunohistochemistry confirmed the follicular dendritic cell lineage of the lesional cells, with positivity for CD21 and CD23. Subsequent lymph node dissection from levels 2A, 2B, 3, and 4 showed features of HV-UCD without residual FDCS. This case highlights the diagnostic challenge FDCS represents, particularly when arising in an unusual location. While complete surgical excision remains the standard of care, long-term follow-up is necessary to monitor for recurrence or metastasis.
期刊介绍：
Pathology International is the official English journal of the Japanese Society of Pathology, publishing articles of excellence in human and experimental pathology. The Journal focuses on the morphological study of the disease process and/or mechanisms. For human pathology, morphological investigation receives priority but manuscripts describing the result of any ancillary methods (cellular, chemical, immunological and molecular biological) that complement the morphology are accepted. Manuscript on experimental pathology that approach pathologenesis or mechanisms of disease processes are expected to report on the data obtained from models using cellular, biochemical, molecular biological, animal, immunological or other methods in conjunction with morphology. Manuscripts that report data on laboratory medicine (clinical pathology) without significant morphological contribution are not accepted.
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