CASE REPORT
Cytokeratin-positive Fibroblastic Reticular Cell Tumor With Follicular Dendritic Cell Features A Case Report and Review of the Literature Naoe Goto, MD, PhD,*w Hisashi Tsurumi, MD, PhD,* Tsuyoshi Takami, MD, PhD,z Manabu Futamura, MD, PhD,y Kasumi Morimitsu, MD, PhD,y Katsuyoshi Takata, MD, PhD,8 Yasuharu Sato, MD, PhD,8z Tadashi Yoshino, MD, PhD,8 Seiji Adachi, MD, PhD,w Koshiro Saito, MD, PhD,w and Mitsunori Yamakawa, MD, PhD#
Abstract: Fibroblastic reticular cell (FRC) neoplasms, which are one of the histiocyte tumor types, are very rare. Here we report a cytokeratin (CK)-positive FRC neoplasm having features of follicular dendritic cells in a 54-year-old woman with right axillary lymph node swelling. The resected lymph node showed multiple nodular aggregations simulating and replacing normal
follicles. The tumor cells had a uniform, large and oval to polygonal shape, abundant cytoplasm, and various sizes of nuclei with central eosinophilic nucleoli and coarse nuclear chromatin. They were positive for CK AE1/AE3+CAM5.2, CK7, tenascin C, l-caldesomone, and CD21, weakly positive for S100, and negative for CD1a. Ultrastructurally, the tumor cells had long interdigitating microvillus-like cell processes and oval to elon-
FIGURE 1. A and B, Enhanced CT revealed right axillary LN swelling (arrow point). C–E, FDG-PET shows abnormally high uptake in the swollen right axillary LNs. From the Departments of *Hematology; yBreast and Molecular Oncology, Gifu University Graduate School of Medicine; wDepartment of Internal Medicine, Gihoku Kosei Hospital; zTokai Clinic, Gifu; 8Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; zDivision of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama; and #Department of Diagnostic Pathology, Yamagata University Faculty of Medicine, Yamagata, Japan. Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Correspondence: Hisashi Tsurumi, MD, PhD, First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan (e-mail: [email protected]). Copyright r 2015 Wolters Kluwer Health, Inc. All rights reserved.
Am J Surg Pathol
Volume 39, Number 4, April 2015
www.ajsp.com |
573
Goto et al
Am J Surg Pathol
gated vesicular nuclei. In addition, the intercellular spaces contained accumulations of collagen, and some tumor cells had desmosomal-like junctions. These findings suggest that the present case is a CK-positive FRC tumor with follicular dendritic cell features. Key Words: fibroblastic reticular cell tumor, FRC neoplasm, cytokeratin-positive FRC tumors (Am J Surg Pathol 2015;39:573–580)
Volume 39, Number 4, April 2015
H
istiocytic neoplasms are extremely rare, probably accounting for
Cytokeratin-positive Fibroblastic Reticular Cell Tumor With Follicular Dendritic Cell Features A Case Report and Review of the Literature Naoe Goto, MD, PhD,*w Hisashi Tsurumi, MD, PhD,* Tsuyoshi Takami, MD, PhD,z Manabu Futamura, MD, PhD,y Kasumi Morimitsu, MD, PhD,y Katsuyoshi Takata, MD, PhD,8 Yasuharu Sato, MD, PhD,8z Tadashi Yoshino, MD, PhD,8 Seiji Adachi, MD, PhD,w Koshiro Saito, MD, PhD,w and Mitsunori Yamakawa, MD, PhD#
Abstract: Fibroblastic reticular cell (FRC) neoplasms, which are one of the histiocyte tumor types, are very rare. Here we report a cytokeratin (CK)-positive FRC neoplasm having features of follicular dendritic cells in a 54-year-old woman with right axillary lymph node swelling. The resected lymph node showed multiple nodular aggregations simulating and replacing normal
follicles. The tumor cells had a uniform, large and oval to polygonal shape, abundant cytoplasm, and various sizes of nuclei with central eosinophilic nucleoli and coarse nuclear chromatin. They were positive for CK AE1/AE3+CAM5.2, CK7, tenascin C, l-caldesomone, and CD21, weakly positive for S100, and negative for CD1a. Ultrastructurally, the tumor cells had long interdigitating microvillus-like cell processes and oval to elon-
FIGURE 1. A and B, Enhanced CT revealed right axillary LN swelling (arrow point). C–E, FDG-PET shows abnormally high uptake in the swollen right axillary LNs. From the Departments of *Hematology; yBreast and Molecular Oncology, Gifu University Graduate School of Medicine; wDepartment of Internal Medicine, Gihoku Kosei Hospital; zTokai Clinic, Gifu; 8Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; zDivision of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama; and #Department of Diagnostic Pathology, Yamagata University Faculty of Medicine, Yamagata, Japan. Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Correspondence: Hisashi Tsurumi, MD, PhD, First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan (e-mail: [email protected]). Copyright r 2015 Wolters Kluwer Health, Inc. All rights reserved.
Am J Surg Pathol
Volume 39, Number 4, April 2015
www.ajsp.com |
573
Goto et al
Am J Surg Pathol
gated vesicular nuclei. In addition, the intercellular spaces contained accumulations of collagen, and some tumor cells had desmosomal-like junctions. These findings suggest that the present case is a CK-positive FRC tumor with follicular dendritic cell features. Key Words: fibroblastic reticular cell tumor, FRC neoplasm, cytokeratin-positive FRC tumors (Am J Surg Pathol 2015;39:573–580)
Volume 39, Number 4, April 2015
H
istiocytic neoplasms are extremely rare, probably accounting for
