Fine needle aspiration cytology of follicular dendritic cell sarcoma of the stomach masquerading as gastrointestinal stromal tumor: A case report of a unique entity with emphasis on cytomorphology.
Alex H ShackletteShaoxiong ChenJohn M DeWittKrunal S PatelOmer A M SaeedPublished in: Diagnostic cytopathology (2023)
Follicular dendritic cell sarcoma (FDCS) is a rare malignant neoplasm, postulated to arise from follicular dendritic cells, with approximately 343 reported cases. Less than 100 cases of FDCS were in the gastrointestinal tract, with only four cases described in the stomach, none of them diagnosed on fine needle aspiration (FNA) cytology. We report here the first case of FDCS of the stomach diagnosed on FNA. Our patient is a 31-year-old male who presented with several years history of intermittent abdominal pain prompting occasional emergency-room visits. Imaging showed a 10.6 cm mass arising from the stomach, concerning for gastrointestinal stromal tumor. FNA cytology was performed using five passes with a 22-gauge needle. The smears were moderately cellular consisting of sheets and large, loosely cohesive clusters of ovoid to spindle cells with indistinct cytoplasmic borders and abundant cytoplasm, peppered with numerous small mature lymphocytes. The nuclei of the tumor cells were oval with finely granular chromatin with frequent nuclear grooves, pseudoinclusions, and easily recognizable mitotic figures. The tumor cells were positive for FDCS markers (CD21, CD23, and CD35).
Keyphrases
- fine needle aspiration
- dendritic cells
- ultrasound guided
- regulatory t cells
- immune response
- abdominal pain
- induced apoptosis
- high resolution
- dna damage
- emergency department
- case report
- public health
- cell cycle
- gene expression
- genome wide
- peripheral blood
- low grade
- signaling pathway
- photodynamic therapy
- nk cells
- fluorescence imaging