Source: Annual Congress 2008 - Mediastinal lesions; rare pathology
Disease area: Thoracic oncology

Abstract

Introduction
Follicular dendritic cell (FDC) sarcomas of mediastinum are generally low-grade and very rare neoplasms. We report this rare case 49-year-old woman with a giant mass with the localization in anterior mediastinum extending to visceral part of mediastium.
Case
The patient complained of anterior chest pain over the previous six months. She had a smoking history of 12 packs of years. Computed tomography showed, a 9x8x8 centimeters diameter smoothly marginated mass lesion. It is contiguous with the arcus aorta, and left pulmonary trunk, truncus of left pulmonary artery, left brachiocephalic vein and left subclavian artery. The tumor was completely removed by median sternotomy. Microscopically, solid-cellular islands were observed between uninvolved normal lymphoid tissues. These solid islands were composed of proliferated spindle-oval shaped cells. Cells were forming fascicles and rarely storiform patterns. Minimal mitotic activity and slight pleomorphism were observed among neoplastic cells. Only individual atypical cells were encountered in some areas. Tumor cells were labeled strongly with CD68. Focal and weak S-100, actin and desmin expression were also seen in some cells. No expressions were detected with CD23, CD1a, CD15, CD30, CD20, CD34 and cytokeratin.
Comment
FDC arises various extranodal sites, most commonly upper aerodigestive tract, intraabdominal sites, and soft tissue
FDS can be confused with thymic epithelial tumor histologically. An accurate diagnosis needs a high index of suspicion and immuhohistochemical evaluation.

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M. Dakak, H. Caylak, O. Yucel, K. Kavakli, E. Sapmaz, S. Cubuk, S. Gurkok, A. Gozubuyuk, O. Genc (Ankara, Turkey). Follicular dendritic cell sarcoma of mediastinum. Eur Respir J 2008; 32: Suppl. 52, 2153

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