• 四川大學(xué)華西醫(yī)院腫瘤中心腫瘤內(nèi)科（成都，610041）;

【摘要】　目的　 總結(jié)濾泡樹突狀細(xì)胞肉瘤的臨床表現(xiàn)，診斷，病理分析及治療。　方法　 2008年9-10月，對1例右扁桃體濾泡樹突狀細(xì)胞肉瘤患者，經(jīng)CT、X線片查示確診后，全麻下行雙側(cè)扁桃體切除術(shù)。　結(jié)果　 術(shù)后病現(xiàn)學(xué)檢查CD21（+），CD23（+），診斷為右扁桃體濾泡樹突狀細(xì)胞肉瘤，術(shù)后予CHOP方案化療并行局部放療。　結(jié)論　 濾泡樹突狀肉瘤是一種罕見的腫瘤，確診主要依靠免疫組織化學(xué)結(jié)果，手術(shù)是首選治療，術(shù)后輔助放化療效果目前不明確。

引用本文： 余敏,姜愚. 扁桃體濾泡樹突狀細(xì)胞肉瘤一例. 華西醫(yī)學(xué), 2010, 25(11): 2064-2066. doi: 復(fù)制

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1. 　Grogg KL, Lae ME, Kurtin PJ, et al. Clusterin expression distinguishes follicular dendritic cell tumors from other dendritic cell neoplasms: report of a novel follicular dendritic cell marker and clinicopathologic data on 12 additional follicular dendritic cell tumors and 6 additional interdigitating dendritic cell tumors[J]. Am J Surg Pathol, 2004, 28(8): 988-998.
2. 　Perez-Ordonez B, Erlandson RA, Rosai J. Follicular dendritic cell tumor. Report of 13 additional cases of a distinctive entity[J]. Am J Surg Pathol, 1996, 20(8): 944-955.
3. 　Chou YY, How SW, Huang GH. Follicular dendritic cell sarcoma of the soft palate[J]. J Formos Med Assoc, 2005, 104(11): 843-847.
4. 　Krber SM, Marx A, Aebert H, et al. Sarcoma of follicular dendritic cells in the dorsal mediastinum[J]. Hum Pathol, 2004, 35(2): 259-263.
5. 　Nakashima T, Kuratomi Y, Shiratsuchi H, et al. Follicular dendritic cell sarcoma of the neck: a case report and literature review[J]. Auris Nasus Larynx, 2002, 29(4): 401-403.
6. 　Monda L, Warnke Rosai J. A primary lymph node malignancy with features suggestive of dendritic reticulum cell differentiation: a report of 4 cases[J]. Am J Pathol, 1986, 122: 562-572.
7. 　曹雪濤. 樹突狀細(xì)胞的基礎(chǔ)與臨床研究新進(jìn)展[J]. 中國免疫學(xué)雜志, 1998, 14(3): 161-168.
8. 　Toyoda K, Taniguchi J, Kikawa K, et al. Follicular dendritic cell sarcoma: ultrastructural and immunohistochemical studies[J]. Intern Med, 2000, 39(11): 950-955.
9. 　Bradshaw EJ, Wood KM, Hodgkinson P, et al. Follicular dendritic cell tumor in a 9-year-old child[J]. Pediatr Blood Cancer, 2005, 45(5): 725-727.
10. 　Shia J, Chen W, Tang LH, et al. Extranodal follicular dendritic cell sarcoma: clinical, pathologic, and histogenetic characteristics of an underrecognized disease entity[J]. Virchows Arch, 2006, 449(2): 148-158.
11. 　Chan JK, Fletcher CD, Nayler SJ. Follicular dendritic cell sarcoma: clinicopathologic analysis of 17 cases suggesting a malignant potential higher than currently recognized[J]. Cancer, 1997, 79: 294-313.
12. 　Chan AC, Chan KW, Chan JK. Development of follicular dendritic cell sarcoma in hyaline-vascular Castlemans disease of the nasopharyns: tracing its evolution sequential biopsies[J]. Histopathology, 2001, 38(6): 510-518.
13. 　Torres U, Hawkins WG, Antonescu CR, et al. Hepatic follicular dendritic cell sarcoma without Epstein-Barr virus expression[J]. Arch Pathol Lab Med, 2005, 129(11): 1480-1483.
14. 　周余, 李杰, 姚曉紅, 等. 濾泡樹突細(xì)胞肉瘤1例[J]. 中華血液學(xué)雜志, 2004, 25(10): 628.
15. 　Perez-Ordonez B, Rosai J. Follicular dendritic cell tumor: review of the entity[J]. Semin Diagn Pathol, 1998, 15(2): 144-154.
16. 　Wang, Kong Y, LU H, et al. Two cases of extranodal follicular dendritic cell sarcoma[J]. Chin Med J, 2003, 116(5): 794-797.
17. 　Romero Guadarrama MB, Reyes Posada O, Hernndez Gonzlez MM, et al. Follicular dendritic cell sarcoma/tumor: 2 cases of a rare tumor of difficult clinical and pathological diagnosis[J]. Ann Diagn Pathol, 2009, 13(4): 257-262.
18. 　皋嵐湘, 丁華野. 關(guān)于組織細(xì)胞腫瘤分類的病理學(xué)新進(jìn)展[J]. 診斷病理學(xué)雜志, 2003, 10(5): 303-306.
19. 　Biddle DA, Ro JY, Yoon GS, et al. Extranodal follicular dendritic cell sarcoma of the head and neck region: three new cases, with a review of the literature[J]. Mod Pathol, 2002, 15(1): 50-58.
20. 　Vargas H, Mouzakes J, Purdy SS, et al. Follicular dendritic cell tumor: an aggressive head and neck tumor[J]. Am J Otolaryngol, 2002, 23(2): 93-98.
21. 　Xie Q, Chen L, Fu K, et al. Podoplanin(d2-40): a new immunohistochemical marker for reactive follicular dendritic cells and follicular dendritic cell sarcoma[J]. Int J Clin Exp Pathol, 2008, 1(3): 276-284.
22. 　Yu H, Gibson JA, Pinkus GS, et al. Podoplanin (D2-40) is a novel marker for follicular dendritic cell tumors[J]. Am J Clin Pathol, 2007, 128(5): 776-782.
23. 　Vermi W, Lonardi S, Bosisio D, et al. Identification of CXCL13 as a new marker for follicular dendritic cell sarcoma[J]. J Pathol, 2008, 216(3): 356-364.
24. 　Sun X, Chang KC, Abruzzo LV, et al. Epidermal growth factor receptor expression in follicular dendritic cells: a shared feature of follicular dendritic cell sarcoma and Castlemans disease[J]. Hum Pathol, 2003, 34(9): 835-840.
25. 　Soriano AO, Thompson MA, Admirand JH, et al. Follicular dendritic cell sarcoma: a report of 14 cases and a review of the literature[J]. Am J Hematol, 2007, 82(8): 725-728.
26. 　Nayler SJ, Taylor L, Cooper K. HHV-8 is not associated with follicular dendritic cell tumors[J]. Mol Pathol, 1998, 51(3): 168-170.
27. 　Zhong GP, Sun WY, Gan MF, et al. Follicular dendritic cell sarcoma: a clinicopathologic study of five cases[J]. Zhonghua Bing Li Xue Za Zhi, 2006, 35(10): 612-615.
28. 　Chan JKC. Proliferative lesions of follicular dendritic cells: an overview, including a detail account of follicular dendritic cell sarcoma, a neoplasm with many faces and uncommon etiologic associations[J]. Adv Anat Pathol, 1997, 4(6): 387-411.
29. 　Shek TWH, Liu CL, Peh WCG, et al. Intra-abdominal follicular dendritic cell tumour: a rare tumour in need of recognition[J]. Histopathology, 1998, 33(5): 465-470.
30. 　Pisani F, Marino M, Sentinelli S, et al. Follicular dendtritic cell sarcoma of the neck: report of a case treated by surgical excision and COP plus (PEG)-liposomal doxorubicin[J]. J Exp Clin Cancer Res, 2008, 27(1): 33.
31. 　Ludwig A. Extanodal follicular dendritic cell sarcoma of the tonsils[J]. HNO, 2006, 54(9): 701-704.
32. 　Azim HA, Elsedewy E, Azim HA Jr. Imatinib in the treatment of follicular dendritic sarcoma: a case report and review of literature[J]. Onkologie, 2007, 30(7): 381-384.
33. 　Della Porta M, Rigolin GM, Bugli AM, et al. Differentiation of follicular dendritic sarcoma cells into functional myeloid-dendritic cell-like elements[J]. Eur J Haematol, 2003, 70(5): 315-318.
34. 　Chera BS, Orlando C, Villaret DB, et al. Follicular dendritic cell sarcoma of the head and neck: case report and literature review[J]. Laryngoscope, 2008, 118(9): 1607-1612.
35. 　Vaideeswar P, George SM, Kane SV, et al. Extranodal follicular cell sarcoma of the tonsil-case report of an epithelioid cell variant with osteoclstic giant cells[J]. Pathol Res Pract, 2009, 205(2): 149-153.
  1. 1. 　Grogg KL, Lae ME, Kurtin PJ, et al. Clusterin expression distinguishes follicular dendritic cell tumors from other dendritic cell neoplasms: report of a novel follicular dendritic cell marker and clinicopathologic data on 12 additional follicular dendritic cell tumors and 6 additional interdigitating dendritic cell tumors[J]. Am J Surg Pathol, 2004, 28(8): 988-998.
  2. 2. 　Perez-Ordonez B, Erlandson RA, Rosai J. Follicular dendritic cell tumor. Report of 13 additional cases of a distinctive entity[J]. Am J Surg Pathol, 1996, 20(8): 944-955.
  3. 3. 　Chou YY, How SW, Huang GH. Follicular dendritic cell sarcoma of the soft palate[J]. J Formos Med Assoc, 2005, 104(11): 843-847.
  4. 4. 　Krber SM, Marx A, Aebert H, et al. Sarcoma of follicular dendritic cells in the dorsal mediastinum[J]. Hum Pathol, 2004, 35(2): 259-263.
  5. 5. 　Nakashima T, Kuratomi Y, Shiratsuchi H, et al. Follicular dendritic cell sarcoma of the neck: a case report and literature review[J]. Auris Nasus Larynx, 2002, 29(4): 401-403.
  6. 6. 　Monda L, Warnke Rosai J. A primary lymph node malignancy with features suggestive of dendritic reticulum cell differentiation: a report of 4 cases[J]. Am J Pathol, 1986, 122: 562-572.
  7. 7. 　曹雪濤. 樹突狀細(xì)胞的基礎(chǔ)與臨床研究新進(jìn)展[J]. 中國免疫學(xué)雜志, 1998, 14(3): 161-168.
  8. 8. 　Toyoda K, Taniguchi J, Kikawa K, et al. Follicular dendritic cell sarcoma: ultrastructural and immunohistochemical studies[J]. Intern Med, 2000, 39(11): 950-955.
  9. 9. 　Bradshaw EJ, Wood KM, Hodgkinson P, et al. Follicular dendritic cell tumor in a 9-year-old child[J]. Pediatr Blood Cancer, 2005, 45(5): 725-727.
  10. 10. 　Shia J, Chen W, Tang LH, et al. Extranodal follicular dendritic cell sarcoma: clinical, pathologic, and histogenetic characteristics of an underrecognized disease entity[J]. Virchows Arch, 2006, 449(2): 148-158.
  11. 11. 　Chan JK, Fletcher CD, Nayler SJ. Follicular dendritic cell sarcoma: clinicopathologic analysis of 17 cases suggesting a malignant potential higher than currently recognized[J]. Cancer, 1997, 79: 294-313.
  12. 12. 　Chan AC, Chan KW, Chan JK. Development of follicular dendritic cell sarcoma in hyaline-vascular Castlemans disease of the nasopharyns: tracing its evolution sequential biopsies[J]. Histopathology, 2001, 38(6): 510-518.
  13. 13. 　Torres U, Hawkins WG, Antonescu CR, et al. Hepatic follicular dendritic cell sarcoma without Epstein-Barr virus expression[J]. Arch Pathol Lab Med, 2005, 129(11): 1480-1483.
  14. 14. 　周余, 李杰, 姚曉紅, 等. 濾泡樹突細(xì)胞肉瘤1例[J]. 中華血液學(xué)雜志, 2004, 25(10): 628.
  15. 15. 　Perez-Ordonez B, Rosai J. Follicular dendritic cell tumor: review of the entity[J]. Semin Diagn Pathol, 1998, 15(2): 144-154.
  16. 16. 　Wang, Kong Y, LU H, et al. Two cases of extranodal follicular dendritic cell sarcoma[J]. Chin Med J, 2003, 116(5): 794-797.
  17. 17. 　Romero Guadarrama MB, Reyes Posada O, Hernndez Gonzlez MM, et al. Follicular dendritic cell sarcoma/tumor: 2 cases of a rare tumor of difficult clinical and pathological diagnosis[J]. Ann Diagn Pathol, 2009, 13(4): 257-262.
  18. 18. 　皋嵐湘, 丁華野. 關(guān)于組織細(xì)胞腫瘤分類的病理學(xué)新進(jìn)展[J]. 診斷病理學(xué)雜志, 2003, 10(5): 303-306.
  19. 19. 　Biddle DA, Ro JY, Yoon GS, et al. Extranodal follicular dendritic cell sarcoma of the head and neck region: three new cases, with a review of the literature[J]. Mod Pathol, 2002, 15(1): 50-58.
  20. 20. 　Vargas H, Mouzakes J, Purdy SS, et al. Follicular dendritic cell tumor: an aggressive head and neck tumor[J]. Am J Otolaryngol, 2002, 23(2): 93-98.
  21. 21. 　Xie Q, Chen L, Fu K, et al. Podoplanin(d2-40): a new immunohistochemical marker for reactive follicular dendritic cells and follicular dendritic cell sarcoma[J]. Int J Clin Exp Pathol, 2008, 1(3): 276-284.
  22. 22. 　Yu H, Gibson JA, Pinkus GS, et al. Podoplanin (D2-40) is a novel marker for follicular dendritic cell tumors[J]. Am J Clin Pathol, 2007, 128(5): 776-782.
  23. 23. 　Vermi W, Lonardi S, Bosisio D, et al. Identification of CXCL13 as a new marker for follicular dendritic cell sarcoma[J]. J Pathol, 2008, 216(3): 356-364.
  24. 24. 　Sun X, Chang KC, Abruzzo LV, et al. Epidermal growth factor receptor expression in follicular dendritic cells: a shared feature of follicular dendritic cell sarcoma and Castlemans disease[J]. Hum Pathol, 2003, 34(9): 835-840.
  25. 25. 　Soriano AO, Thompson MA, Admirand JH, et al. Follicular dendritic cell sarcoma: a report of 14 cases and a review of the literature[J]. Am J Hematol, 2007, 82(8): 725-728.
  26. 26. 　Nayler SJ, Taylor L, Cooper K. HHV-8 is not associated with follicular dendritic cell tumors[J]. Mol Pathol, 1998, 51(3): 168-170.
  27. 27. 　Zhong GP, Sun WY, Gan MF, et al. Follicular dendritic cell sarcoma: a clinicopathologic study of five cases[J]. Zhonghua Bing Li Xue Za Zhi, 2006, 35(10): 612-615.
  28. 28. 　Chan JKC. Proliferative lesions of follicular dendritic cells: an overview, including a detail account of follicular dendritic cell sarcoma, a neoplasm with many faces and uncommon etiologic associations[J]. Adv Anat Pathol, 1997, 4(6): 387-411.
  29. 29. 　Shek TWH, Liu CL, Peh WCG, et al. Intra-abdominal follicular dendritic cell tumour: a rare tumour in need of recognition[J]. Histopathology, 1998, 33(5): 465-470.
  30. 30. 　Pisani F, Marino M, Sentinelli S, et al. Follicular dendtritic cell sarcoma of the neck: report of a case treated by surgical excision and COP plus (PEG)-liposomal doxorubicin[J]. J Exp Clin Cancer Res, 2008, 27(1): 33.
  31. 31. 　Ludwig A. Extanodal follicular dendritic cell sarcoma of the tonsils[J]. HNO, 2006, 54(9): 701-704.
  32. 32. 　Azim HA, Elsedewy E, Azim HA Jr. Imatinib in the treatment of follicular dendritic sarcoma: a case report and review of literature[J]. Onkologie, 2007, 30(7): 381-384.
  33. 33. 　Della Porta M, Rigolin GM, Bugli AM, et al. Differentiation of follicular dendritic sarcoma cells into functional myeloid-dendritic cell-like elements[J]. Eur J Haematol, 2003, 70(5): 315-318.
  34. 34. 　Chera BS, Orlando C, Villaret DB, et al. Follicular dendritic cell sarcoma of the head and neck: case report and literature review[J]. Laryngoscope, 2008, 118(9): 1607-1612.
  35. 35. 　Vaideeswar P, George SM, Kane SV, et al. Extranodal follicular cell sarcoma of the tonsil-case report of an epithelioid cell variant with osteoclstic giant cells[J]. Pathol Res Pract, 2009, 205(2): 149-153.