Dendritic cell tumors are extremely rare neoplasms arising from antigen-presenting cells of the immune system. We report a case of a 69-year-old man with an unremarkable medical history who presented with a 2-months history of a gradually enlarging painless, firm, mobile, 2 × 2-cm swelling at the caudal pole of the left parotid gland without systemic symptoms. Histologically, the tumor consisted of a spindle cell proliferation in an intraparotideal lymph node. Based on the histopathologic, immunohistochemical and electron microscopic findings, a dendritic cell tumor, not otherwise specified (NOS) in an intraparotideal lymph node was diagnosed.
The patient underwent complete tumor resection, and is currently free of disease, 2 years after surgery. These extremely rare tumors must be distinguished from other more common tumors in the salivary glands. Awareness that dendritic cell tumors may occur in this localization, careful histologic evaluation and ancillary immunohistochemical and electron microscopical analyses should allow for recognition of this entity.
Dendritic cell tumorsalivary gland lymph node
Dendritic cell sarcomas (DCS) are exceedingly rare entities, arising from antigen-presenting cells of the immune system. DCS are subclassified into the better characterized follicular (FDCS)  and interdigitating (IDCS)  dendritic cell sarcomas and other rare and less well classifiable dendritic cell tumors like fibroblastic reticular cell tumors, indeterminate dendritic cell tumors and dendritic cell tumors, not otherwise specified (DCT, NOS) . DCS was first described in 1986 by Monda et al. . Since then, nearly 300 cases, most of them FDCS, have been described in the literature. Although most DCS evolve in cervical, mediastinal, axillary and inguinal lymph nodes, also extranodal manifestations have been described . The clinical behaviour of DCS is similar to that of low-grade soft tissue sarcoma, with an approximately 30% overall risk for developing local recurrences and metastases . Because of the rareness of the disease a standardized treatment is lacking.
We herein report a case of a dendritic cell tumor, NOS of an intraparotideal lymph node, emphasizing the important role of ancillary immunohistochemical and molecular studies in establishing this extraordinarily rare diagnosis.
A 69-year-old man presented with a 2-months history of a gradually enlarging painless, firm, mobile, 2 × 2 × 2 cm swelling at the caudal pole of the left parotid gland without systemic symptoms. His medical history was unremarkable.
Magnet resonance imaging (MRI) showed a 2 × 2 × 2 cm mass with hyperintense signal on T2-weighted images and hypointense signal on T1-weighted sequences and a contrast enhancement which bordered directly to the lateral part of left sternocleidomastoid muscle and displaced the external jugular vein dorsally. Cranially there was no clear demarcation to the left parotid gland (Figure 1). The patient underwent surgical excision of the swelling by a partial left parotidectomy with preservation of the facial nerve. Because of insecure R0-status a follow-up resection with extended partial parotidectomy and ipsilateral selective neck dissection (levels II and III) was conducted. A primary tumor of the upper aerodigestive tract was excluded by panendoscopy. Subsequent total body positron emission tomography with 18-F-fluorodesoxyglucose and computed tomography scan 6 months after surgery were unremarkable. The patient is currently disease free, 2 years after surgery.
The specimen consisted of parotid gland tissue containing a single firm, nodule 2.3 cm in diameter. The cut surface was soft and homogeneous light-grey. Microscopic examination revealed a spindle cell neoplasia in an intraparotideal lymph node. Tumor cells featured moderate nuclear pleomorphism, bulked chromatin and a clearly perceptible nucleolus (Figure 2A, B). Furthermore an elevated mitotic rate (up to 27 mitoses per 10 high power fields) was found.
To further characterize the histogenesis of this tumor, immunohistochemical stainings were performed. The tumor cells were positive for vimentin, fascin and HLA-DR (Figure 2B, D). In contrast, the neoplastic cells were negative for all epithelial, melanocytic, lymphoid, histocytic and follicular dendritic cell markers used. The proliferation, as assessed by Mib1 index was 40-50%. The results of the immuohistochemical stainings are shown in table 1.
Electron Microscopic Findings
The electron microscopical aspect of the tissue was characterized by cells which were devoid of characteristic structures as desmosomes or Birbeck granules. There was a certain heterogeneity of nuclei concerning their amount of heterochromatin. However, the cytoplasm of the cells (size, content of mitochondria or endoplasmatic reticulum) was less well differentiated (Figure 3A). The most prominent finding was the large number of slender long-spacing collagen fibers dividing the tissue in many compartments (Figure 3A). Fibrous long-spacing collagen the period length of which was in the order of 200 nm in this case (Figure 3B), is not described in the literature to be specific for any disease, but has been found in a variety of normal and pathological tissues. Therefore, it cannot be used as a pathognomonic marker here.
In summary, the morphological and immunophenotypic features were consistent with a dendritic cell tumor, not otherwise specified (NOS) originating in an intraparotideal lymph node. A differentiation towards a follicular or interdigitating dendritic cell sarcoma could not be demonstrated.
Dendritic cell sarcomas (DCS) are rare neoplasms arising from antigen-presenting cells of the immune system . DCS are being recognized with an increasing frequency. These tumors can occur, where dendritic cells are located. One of the most common manifestation sites are the head and neck region. Under-recognition of this entity may contribute to its rarity. The WHO subclassifies DCS into five groups : Langerhans cell histiocytosis, Langerhans cell sarcoma, interdigitating dendritic cell sarcoma (IDCS), follicular dendritic cell sarcoma (FDCS) and other rare and less well classifiable dendritic cell tumors like fibroblastic reticular cell tumors, indeterminate dendritic cell tumors and dendritic cell tumors, not otherwise specified (DCT, NOS) . FDCS is the most common subtype followed by IDCS.
The clinical course of this neoplasia is similar to that of soft tissue sarcomas [3, 6]. Since only 306 cases of DCS have been reported worldwide (table 2), there is no general consensus on the treatment of this rare disease. Surgery has remained the gold standard in localized disease, but a recurrence rate up to 50% has been reported . Alternatively some DCS have also been treated additionally by radiotherapy and or chemotherapy . For our patient we chose the option of surgical therapy and he is well and free of disease for 2 years after surgery now.
FDCS, follicular dendritic cell sarcoma; IDCS, interdigitating cell sarcoma. * Modified from . A total of 145 nodal FDCS cases, 85 extranodal FDCS cases, 47 nodal IDCS cases and 29 extranodal cases have been reported until 08/2011. 2 cases FDCS and 2 cases of IDCS occured in the parotid gland.
For establishing the diagnosis a large number of immunohistochemical stainings and ultrastructural analyses has been performed. Other rare differential diagnosis of salivary glands, like lipomatous pleomorphic adenoma  or sebaceous adenoma , were excluded. Despite this extensive work-up a definite assignation to an established entity of dendritic cell tumors could not be achieved. Therefore a diagnosis of dendritic cell tumor, NOS was made.
In summary, we report on the clinical, pathologic, and immunohistochemical features of a dendritic cell tumor, NOS in an intraparotideal lymph node. Metastatic disease was ruled out by PET- and CT imaging. Recognition of this extremely rare tumor, and its distinction from more common malignant tumors of lymph nodes and salivary glands largely depends on judicious application of immunohistochemical and ultrastructural techniques. The precise histogenesis of these extraordinarily rare tumors remains to be established.
Written informed consent was obtained from the patient for publication of this Case Report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
This publication was funded by the German Research Foundation (DFG) and the University of Wuerzburg in the funding programme Open Access Publishing.
Department of Otolaryngology, Head and Neck Surgery, University of Tübingen
Department of Otolaryngology, Head and Neck Surgery, University of Halle-Wittenberg
Department of Diagnostic and Interventional Radiology, University of Tübingen
Institute of Pathology and Comprehensive Cancer Center (CCC), University of Tübingen
University of Würzburg, Department of Otolaryngology, Head and Neck Surgery
Chan JKC: Follicular dendritic cell sarcoma. In WHO Classification of tumors of haematopoietic and lymphoid tissue. WHO; 2008:363–364.
Weiss LMG, T M, Chan JKC: Interdigitating dendritic cell sarcoma. 2008.
Monda L, Warnke R, Rosai J: A primary lymph node malignancy with features suggestive of dendritic reticulum cell differentiation. A report of 4 cases.Am J Pathol 1986,122(3):562–572.PubMed
Li L, Shi YH, Guo ZJ, Qiu T, Guo L, Yang HY, Zhang X, Zhao XM, Su Q: Clinicopathological features and prognosis assessment of extranodal follicular dendritic cell sarcoma.World J Gastroenterol 2010,16(20):2504–2519.PubMedView Article
De Pas T, Spitaleri G, Pruneri G, Curigliano G, Noberasco C, Luini A, Andreoni B, Testori A, de Braud F: Dendritic cell sarcoma: an analytic overview of the literature and presentation of original five cases.Crit Rev Oncol Hematol 2008,65(1):1–7.PubMedView Article
Perez-Ordonez B, Erlandson RA, Rosai J: Follicular dendritic cell tumor: report of 13 additional cases of a distinctive entity.Am J Surg Pathol 1996,20(8):944–955.PubMedView Article
Efune G, Sumer BD, Sarode VR, Wang HY, Myers LL: Interdigitating dendritic cell sarcoma of the parotid gland: case report and literature review.Am J Otolaryngol 2009,30(4):264–268.PubMedView Article
Kondo T: A case of lipomatous pleomorphic adenoma in the parotid gland: a case report.Diagn Pathol 2009, 4:16.PubMedView Article
Bersch C, Back W: Primary sebacous adenoma of the salivary glands - a rare differential diagnosis: report of a case.Diagn Pathol 2007,2(Suppl 1):16.View Article
Aboujaoude R, Alvarez JR, Alvarez M, Al-Khan A: Follicular dendritic cell sarcoma in pregnancy: case report and review of the literature.Am J Perinatol 2006,23(8):459–461.PubMedView Article
Amiri-Kordestani L, Priebat D, Chia SH: Follicular dendritic cell sarcoma of the neck: case report and review of current diagnostic and management strategies.Ear Nose Throat J 2010,89(7):E14–17.PubMed
Aydin E, Ozluoglu LN, Demirhan B, Arikan U: Follicular dendritic cell sarcoma of the tonsil: case report.Eur Arch Otorhinolaryngol 2006,263(12):1155–1157.PubMedView Article
Azim HA, Elsedewy E, Azim HA Jr: Imatinib in the treatment of follicular dendritic sarcoma: a case report and review of literature.Onkologie 2007,30(7):381–384.PubMedView Article
Boldin I, Brix-Grunwald G, Scarpatetti MM, Beham-Schmid C, Klein A: Interdigitating dendritic cell sarcoma of the eyelid with a rapidly fatal course.Arch Ophthalmol 2008,126(5):738–740.PubMedView Article
Cano JR, Cerezo F, Gonzalez A, Marchal T, Salvatierra A: [Follicular dendritic cell tumour in the anterior mediastinum].Cir Esp 2009,85(4):254–256.PubMedView Article
Chera BS, Orlando C, Villaret DB, Mendenhall WM: Follicular dendritic cell sarcoma of the head and neck: case report and literature review.Laryngoscope 2008,118(9):1607–1612.PubMedView Article
Choi JW, Lee JH, Kim A, Kim CH, Chae YS, Kim I: Follicular dendritic cell sarcoma arising in the dura mater of the spine.Arch Pathol Lab Med 2006,130(11):1718–1721.PubMed
Choi BS, Baek JH, Shin YM, Kim JH, Kim HW, Lee SJ, Cha HJ: Follicular dendritic cell sarcoma: a case report and review of the literature.Cancer Res Treat 2010,42(2):121–124.PubMedView Article
Clement P, Saint-Blancard P, Minvielle F, Le Page P, Kossowski M: Follicular dendritic cell sarcoma of the tonsil: a case report.Am J Otolaryngol 2006,27(3):207–210.PubMedView Article
Cossu A, Deiana A, Lissia A, Dedola MF, Cocco L, Palmieri G, Tanda F: Synchronous interdigitating dendritic cell sarcoma and B-cell small lymphocytic lymphoma in a lymph node.Arch Pathol Lab Med 2006,130(4):544–547.PubMed
Cyriac S, Praveenkumar D, Majhi U, Sagar TG: Follicular dendritic cell sarcoma of the neck with an aggressive and fatal course.J Cancer Res Ther 2010,6(1):114–116.PubMedView Article
Denning KL, Olson PR, Maley RH Jr, Flati VR, Myers JL, Silverman JF: Primary pulmonary follicular dendritic cell neoplasm: a case report and review of the literature.Arch Pathol Lab Med 2009,133(4):643–647.PubMed
Duan GJ, Wu F, Zhu J, Guo DY, Zhang R, Shen LL, Wang SH, Li Q, Xiao HL, Mou JH, et al.: Extranodal follicular dendritic cell sarcoma of the pharyngeal region: a potential diagnostic pitfall, with literature review.Am J Clin Pathol133(1):49–58.
Encabo RS, McHugh J, Carrau RL, Kassam A, Heron D: Follicular dendritic cell sarcoma of the nasopharynx.Am J Otolaryngol 2008,29(4):262–264.PubMedView Article
Eun YG, Kim SW, Kwon KH: Follicular dendritic cell sarcoma of the tonsil.Yonsei Med J 2010,51(4):602–604.PubMedView Article
Fan YS, Ng WK, Chan A, Chan GS, Tsang J, Chim CS, Ip P: Fine needle aspiration cytology in follicular dendritic cell sarcoma: a report of two cases.Acta Cytol 2007,51(4):642–647.PubMedView Article
Fraser CR, Wang W, Gomez M, Zhang T, Mathew S, Furman RR, Knowles DM, Orazi A, Tam W: Transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma to interdigitating dendritic cell sarcoma: evidence for transdifferentiation of the lymphoma clone.Am J Clin Pathol 2009,132(6):928–939.PubMedView Article
Gach JE, Carr RA, Charles-Holmes R: Nodal follicular dendritic cell sarcoma of the axilla presenting as cellulitis.Br J Dermatol 2006,154(1):177–178.PubMedView Article
Gong QX, Fan QH, Zhou ZS, Zhang ZH, Yu MN, Wang Z, Wang C, Zhang WM: [Inflammatory pseudotumor-like follicular dendritic cell tumor of spleen].Zhonghua Bing Li Xue Za Zhi 2008,37(1):40–44.PubMed
Gordon MK, Kraus M, van Besien K: Interdigitating dendritic cell tumors in two patients exposed to topical calcineurin inhibitors.Leuk Lymphoma 2007,48(4):816–818.PubMedView Article
Granados R, Aramburu JA, Rodriguez JM, Nieto MA: Cytopathology of a primary follicular dendritic cell sarcoma of the liver of the inflammatory pseudotumor-like type.Diagn Cytopathol 2008,36(1):42–46.PubMedView Article
Han HS, Lee OJ, Lim SN, An JY, Lee KM, Choe KH, Lee KH, Kim ST: Extranodal interdigitating dendritic cell sarcoma presenting in the pleura: a case report.J Korean Med Sci 2011,26(2):304–307.PubMedView Article
Hartert M, Strobel P, Dahm M, Nix W, Marx A, Vahl CF: A follicular dendritic cell sarcoma of the mediastinum with immature T cells and association with myasthenia gravis.Am J Surg Pathol 2010,34(5):742–745.PubMed
Hollingsworth J, Cooper WA, Nicoll KD, Wills EJ, Thiruvilangam V, Lee CS, Scolyer RA: Follicular dendritic cell sarcoma of the lung: a report of two cases highlighting its pathological features and diagnostic pitfalls.Pathology 2011,43(1):67–70.PubMedView Article
Ishihara S, Honda Y, Asato T, Nonaka M, Nakagawa S, Hirashima K, Hayashi N, Baba H, Iyama K: Interdigitating dendritic cell sarcoma of the ileum recurred in multiple lymph nodes and duodenum three years after operation without chemotherapy.Pathol Res Pract 2010,206(7):514–518.PubMedView Article
Jiang L, Admirand JH, Moran C, Ford RJ, Bueso-Ramos CE: Mediastinal follicular dendritic cell sarcoma involving bone marrow: a case report and review of the literature.Ann Diagn Pathol 2006,10(6):357–362.PubMedView Article
Jo S, Babb MJ, Hilsinger RL Jr: Interdigitating dendritic cell sarcoma of cervical lymph nodes.Arch Otolaryngol Head Neck Surg 2006,132(11):1257–1259.PubMedView Article
Kanaan H, Al-Maghrabi J, Linjawi A, Al-Abbassi A, Dandan A, Haider AR: Interdigitating dendritic cell sarcoma of the duodenum with rapidly fatal course: a case report and review of the literature.Arch Pathol Lab Med 2006,130(2):205–208.PubMed
Kapucuoglu N, Percinel S, Ventura T, Lang R, Al-Daraji W, Eusebi V: Dendritic cell sarcomas/tumours of the breast: report of two cases.Virchows Arch 2009,454(3):333–339.PubMedView Article
Karaman E, Saritzali G, Kilic E, Korkut N, Enver O: Follicular dendritic cell sarcoma of the parotid gland recurring 6 times within 12 years.J Craniofac Surg 2009,20(6):2171–2172.PubMedView Article
Khalid S, Yaqoob N, Pervez S: Follicular dendritic cell sarcoma of lymph node--a rare entity.J Pak Med Assoc 2006,56(3):137–139.PubMed
Kim SY, Kang JH, Chun SH, Chang MH, Kim YS, Lee SN, Kim MS, Kang CS: Interdigitating dendritic cell sarcoma of the tonsil.Asia Pac J Clin Oncol 2010,6(3):144–148.PubMedView Article
Kim H, Park CM, Jeon YK, Yoo IR, Song SW, Goo JM, Lee HJ: Computed Tomography and 18F-fluoro-2-deoxyglucose Positron Emission Tomography Findings of Primary Pulmonary Follicular Dendritic Cell Sarcoma: Case Report and a Literature Review.J Thorac Imaging 2011.
Kovacs RB, Sattar HA, Krausz T, Kas J, Berta M, Sapi Z: Primary follicular dendritic cell sarcoma of the lung.Histopathology 2006,49(4):431–433.PubMedView Article
Kure K, Khader SN, Suhrland MJ, Ratech H, Grossberg R, Oktay MH: Fine needle aspiration of follicular dendritic cell sarcoma in an HIV-positive man: a case report.Acta Cytol 2010,54(5):707–711.PubMed
Leipsic JA, McAdams HP, Sporn TA: Follicular dendritic cell sarcoma of the mediastinum.AJR Am J Roentgenol 2007,188(6):W554–556.PubMedView Article
Li J, Duan MH, Han B, Zhang W, Zhou DB, Zhao YQ, Shen T: [Dendritic cell sarcoma: 4 cases report with literature review].Zhonghua Xue Ye Xue Za Zhi 2008,29(4):263–266.PubMed
Liu X, Deng Y, Zhang X, Mukherjee R, Huang W, Zhang G, Wang H, Li X: Interdigitating dendritic cell sarcoma following adult liver transplantation: case report and literature review.Pathol Oncol Res 2011,17(2):397–402.PubMedView Article
Long-Hua Q, Qin X, Ya-Jia G, Jian W, Xiao-Yuan F: Imaging findings of follicular dendritic cell sarcoma: report of four cases.Korean J Radiol 2011,12(1):122–128.PubMedView Article
Low SE, Menasce LP, Manson CM: Follicular dendritic cell sarcoma: a rare tumor presenting as an abdominal mass.Int J Surg Pathol 2007,15(3):315–317.PubMedView Article
Ludwig A: [Extranodal follicular dendritic cell sarcoma of the tonsils].Hno 2006,54(9):701–704.PubMedView Article
Majhi U, Shirley S, Murhekar K: Follicular dendritic cell sarcoma of oral cavity: report of 2 cases.Indian J Pathol Microbiol 2007,50(3):545–547.PubMed
Martins PN, Reddy S, Martins AB, Facciuto M: Follicular dendritic cell sarcoma of the liver: unusual presentation of a rare tumor and literature review.Hepatobiliary Pancreat Dis Int 2011,10(4):443–445.PubMed
Miyagi T, Nagasaki A, Shinzato O, Ohshima K, Takasu N: [Interdigitating dendritic cell sarcoma/tumor--a case report].Gan To Kagaku Ryoho 2007,34(3):469–471.PubMed
Padilla-Rodriguez AL, Bembassat M, Lazaro M, Ortiz-Hidalgo C: Intra-abdominal follicular dendritic cell sarcoma with marked pleomorphic features and aberrant expression of neuroendocrine markers: report of a case with immunohistochemical analysis.Appl Immunohistochem Mol Morphol 2007,15(3):346–352.PubMedView Article
Pisani F, Marino M, Sentinelli S, Petti MC: Follicular dendritic cell sarcoma of the neck: report of a case treated by surgical excision and COP plus (PEG)-liposomal doxorubicin.J Exp Clin Cancer Res 2008, 27:33.PubMedView Article
Pizzi M, Ludwig K, Palazzolo G, Busatto G, Rettore C, Altavilla G: Cervical follicular dendritic cell sarcoma: a case report and review of the literature.Int J Immunopathol Pharmacol 2011,24(2):539–544.PubMed
Romero-Guadarrama MB, Reyes-Posada O, Hernandez-Gonzalez MM, Duran-Padilla MA: Follicular dendritic cell sarcoma/tumor: 2 cases of a rare tumor of difficult clinical and pathological diagnosis.Ann Diagn Pathol 2009,13(4):257–262.PubMedView Article
Sander B, Middel P, Gunawan B, Schulten HJ, Baum F, Golas MM, Schulze F, Grabbe E, Parwaresch R, Fuzesi L: Follicular dendritic cell sarcoma of the spleen.Hum Pathol 2007,38(4):668–672.PubMedView Article
Shen SC, Wu CC, Ng KF, Wu RC, Chen HM, Chen TC: Follicular dendritic cell sarcoma mimicking giant cell carcinoma of the pancreas.Pathol Int 2006,56(8):466–470.PubMedView Article
Shen DP, Ni XZ, Yin XL, Wu ZY: Clinical and pathological features of follicular dendritic cell sarcoma of appendix: a case report.Chin Med J (Engl) 2009,122(13):1595–1597.
Silver AL, Faquin WC, Caruso PA, Deschler DG: Follicular dendritic cell sarcoma presenting in the submandibular region in an 11 year-old.Laryngoscope 2011,120(Suppl 4):S183.
Soriano AO, Thompson MA, Admirand JH, Fayad LE, Rodriguez AM, Romaguera JE, Hagemeister FB, Pro B: Follicular dendritic cell sarcoma: a report of 14 cases and a review of the literature.Am J Hematol 2007,82(8):725–728.PubMedView Article
Suhail Z, Musani MA, Afaq S, Zafar A, Ahmed Ashrafi SK: Follicular dendritic cell sarcoma of tonsil.J Coll Physicians Surg Pak 2010,20(1):55–56.PubMed
Suzuki N, Katsusihma H, Takeuchi K, Nakamura S, Ishizawa K, Ishii S, Moriya T, DeCoteau JF, Miura I, Ichinohasama R: Cytogenetic abnormality 46, XX, add(21)(q11.2) in a patient with follicular dendritic cell sarcoma.Cancer Genet Cytogenet 2008,186(1):54–57.PubMedView Article
Tokyol C, Yilmaz MD, Ekici O, Aktepe F: Follicular dendritic cell sarcoma: a case report.Acta Cytol 2008,52(2):235–239.PubMedView Article
Tu XY, Sheng WQ, Lu HF, Wang J: [Clinicopathologic study of intraabdominal extranodal follicular dendritic cell sarcoma].Zhonghua Bing Li Xue Za Zhi 2007,36(10):660–665.PubMed
Vaideeswar P, George SM, Kane SV, Chaturvedi RA, Pandit SP: Extranodal follicular dendritic cell sarcoma of the tonsil - case report of an epithelioid cell variant with osteoclastic giant cells.Pathol Res Pract 2009,205(2):149–153.PubMedView Article
Vives S, Fernandez MT, Lopez de Castro PE, Ribera JM: [Interdigitating dendritic cell sarcoma with localization to the lung].Med Clin (Barc) 2006,126(14):559.View Article
Voigt LP, Hmidi A, Pastores SM, Maki RG, Carlson DL, Bains MS, Halpern NA: Management dilemmas due to a paratracheal follicular dendritic cell tumor.Ann Thorac Surg 2006,82(5):1898–1900.PubMedView Article
Wang LF, Wang RF, Wang ZC, Han W, Mei HL, Liu M: [Follicular dendritic cell sarcoma of stomach: report of a case].Zhonghua Bing Li Xue Za Zhi 2008,37(3):210–211.PubMed
Wang XI, Zhang S, Thomas JO, Adegboyega PA: Cytomorphology, ultrastructural, and cytogenetic findings in follicular dendritic cell sarcoma: a case report.Acta Cytol 2010,54(5 Suppl):759–763.PubMed
Wang H, Su Z, Hu Z, Wen J, Liu B: Follicular dendritic cell sarcoma: a report of six cases and a review of the Chinese literature.Diagn Pathol 2010, 5:67.PubMedView Article
Wang Q, An L, Cui N, Sha J, Zhu D: [Follicular dendritic cell sarcoma: a case report and review of literature].Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011,25(3):100–102.PubMed
Wu Q, Liu C, Lei L, Yan X, Wang B, Liu X, Yv L, Lv Y: Interdigitating dendritic cell sarcoma involving bone marrow in a liver transplant recipient.Transplant Proc 2010,42(5):1963–1966.PubMedView Article
Yakushijin Y, Shikata H, Kito K, Ohshima K, Kojima K, Hato T, Hasegawa H, Yasukawa M: Follicular dendritic cell tumor as an unknown primary tumor.Int J Clin Oncol 2007,12(1):56–58.PubMedView Article
Yamada Y, Haga H, Hernandez M, Kubota KC, Orii F, Nagashima K, Matsuno Y: Follicular dendritic cell sarcoma of small intestine with aberrant T-cell marker expression.Pathol Int 2009,59(11):809–812.PubMedView Article
Yang GC, Wang J, Yee HT: Interwoven dendritic processes of follicular dendritic cell sarcoma demonstrated on ultrafast papanicolaou-stained smears: a case report.Acta Cytol 2006,50(5):534–538.PubMedView Article
Yu L, Yang SJ: Primary Follicular Dendritic Cell Sarcoma of the Thyroid Gland Coexisting With Hashimoto's Thyroiditis.Int J Surg Pathol 2009.
Zhang ZX, Cheng J, Shi QL, Ma J, Zhou XJ, Zhou HB, Ma HH: [Follicular dendritic cell sarcoma: a clinicopathologic study of 8 cases].Zhonghua Bing Li Xue Za Zhi 2008,37(6):395–399.PubMed
Zhong GP, Sun WY, Gan MF, Yuan MC: [Follicular dendritic cell sarcoma: a clinicopathologic study of five cases].Zhonghua Bing Li Xue Za Zhi 2006,35(10):612–615.PubMed
Zhou ZY, Sun RC, Yang SD, Liang JB, Rui J, Pan MH: Interdigitating dendritic cell tumor of the lymph node in the right submaxillary region: a case report and review of the literature.Int J Surg Pathol 2011,19(1):88–92.PubMed
Zivkovic V, Basic M, Gligorijevic J, Pavlovic V, Lazarevic V, Petrovic A: Follicular dendritic cell sarcoma in the lymph nodes of the neck.Bratisl Lek Listy 2007,108(8):368–370.PubMed
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