HAEM4Backup:Follicular Dendritic Cell Sarcoma
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Primary Author(s)*
Anna Heimes Dillon, MD and Shivani Golem, PhD, FACMG
Cancer Category/Type
Histiocytic and Dendritic Cell Neoplasms (WHO 4th ed.)[1]
Stroma-derived neoplasms of lymphoid tissues (WHO 5th ed.)[2]
Cancer Sub-Classification / Subtype
Mesenchymal dendritic cell neoplasms (WHO 5th ed.)[2]
Definition / Description of Disease
Follicular dendritic cell sarcoma (FDCS) is a neoplasm with morphologic and immunophenotypic features of follicular dendritic cells, which are normally present in lymphoid follicles and are derived from mesenchymal cells of lymphoid tissues.
Synonyms / Terminology
Follicular dendritic cell tumor
Dendritic reticulum cell tumor (no longer used)
Epidemiology / Prevalence
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Clinical Features
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Sites of Involvement
- Extranodal sites (79%)
- Liver, spleen, and GI tract most common
- Any site may be involved
- Lymph nodes (~15%)[3]
Morphologic Features
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Immunophenotype[1][3]
| Finding | Marker |
|---|---|
| Positive (lineage-defining) | One or more of CD21, CD23, CD35 |
| Positive (frequent) | CXCL13, clusterin, podoplanin, fascin, vimentin |
| Positive (variable) | CD68, EMA, S100 |
| Negative (universal) | CD1a, langerin, CD34, CD45, lysozyme, CD163, MPO, CD3, CD79a, cytokeratins, HMB-45 |
Chromosomal Rearrangements (Gene Fusions)
The following rearrangements have been reported in individual cases, but whether they are recurrent is not yet known.
| Chromosomal Rearrangement | Genes in Fusion (5’ or 3’ Segments) | Pathogenic Derivative | Prevalence |
|---|---|---|---|
| EXAMPLE t(9;22)(q34;q11.2) | EXAMPLE 3'ABL1 / 5'BCR | EXAMPLE der(22) | EXAMPLE 5% |
| EXAMPLE t(8;21)(q22;q22) | EXAMPLE 5'RUNX1 / 3'RUNXT1 | EXAMPLE der(8) | EXAMPLE 5% |
Characteristic Chromosomal Aberrations / Patterns
Although no recurrent chromosomal alterations have been identified in FDCS, the tumors often show complex karyotypes with loss of whole or partial chromosomes being the most frequent aberration. Losses frequently occur in regions harboring important tumor suppressor genes.[3]
Genomic Gain/Loss/LOH
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| Chromosome Number | Gain/Loss/Amp/LOH | Region |
|---|---|---|
| EXAMPLE 8 | EXAMPLE Gain | EXAMPLE chr8:0-1000000 |
| EXAMPLE 7 | EXAMPLE Loss | EXAMPLE chr7:0-1000000 |
Gene Mutations (SNV/INDEL)
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| Gene | Mutation | Oncogene/Tumor Suppressor/Other | Presumed Mechanism (LOF/GOF/Other; Driver/Passenger) | Prevalence (COSMIC/TCGA/Other) |
|---|---|---|---|---|
| CDKN2A | Copy number loss | Tumor Suppressor | ||
| NFKBIA | ||||
| TP53 | ||||
| BIRC3 | ||||
| CCND2 | ||||
| BRAF | p.V600E | 0-19% | ||
| TRAF3 | ||||
| TNFAIP3 | ||||
| RB1 | ||||
| CDK4/MDM2 | ||||
| PTEN | ||||
| JAK2 | ||||
| SOCS3 | ||||
| BRCA1/BRCA2 | ||||
| KRAS | ||||
| MYC | ||||
Other Mutations
| Type | Gene/Region/Other |
|---|---|
| Concomitant Mutations | EXAMPLE IDH1 R123H |
| Secondary Mutations | EXAMPLE Trisomy 7 |
| Mutually Exclusive | EXAMPLE EGFR Amplification |
Epigenomics (Methylation)
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Genes and Main Pathways Involved
FDCS primarily shows alterations in the NF-κB signaling pathway. Unlike the dendritic cell and histiocytic neoplasms of hematopoietic origin, aberrations in the MAPK pathway are uncommon.
Diagnostic Testing Methods
The only current method of diagnosis is tissue biopsy with immunohistochemistry. FDCS must be differentiated from other mesenchymal dendritic cell neoplasms, histiocytic and dendritic cell neoplasms, and non-hematopoietic tumors such as carcinoma, sarcoma, or melanoma which may show histologic similarities.
Clinical Significance (Diagnosis, Prognosis and Therapeutic Implications)
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Familial Forms
- None known
Other Information
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Links
Inflammatory Pseudotumor-Like Follicular/Fibroblastic Dendritic Cell Sarcoma
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References
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- ↑ 1.0 1.1 Chan JKC, et al., (2017). Follicular dendritic cell sarcoma, in World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues, Revised 4th edition. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Arber DA, Hasserjian RP, Le Beau MM, Orazi A, and Siebert R, Editors. IARC Press: Lyon, France, p129-171.
- ↑ 2.0 2.1 Alaggio, Rita; et al. (2022-07). "The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms". Leukemia. 36 (7): 1720–1748. doi:10.1038/s41375-022-01620-2. ISSN 1476-5551. PMC 9214472 Check
|pmc=value (help). PMID 35732829 Check|pmid=value (help). Check date values in:|date=(help) - ↑ 3.0 3.1 3.2 Facchetti, Fabio; et al. (2021-10). "Follicular dendritic cell sarcoma". Pathologica. 113 (5): 316–329. doi:10.32074/1591-951X-331. ISSN 1591-951X. PMC 8720404 Check
|pmc=value (help). PMID 34837090 Check|pmid=value (help). Check date values in:|date=(help)
EXAMPLE Book
- Arber DA, et al., (2017). Acute myeloid leukaemia with recurrent genetic abnormalities, in World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues, Revised 4th edition. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Arber DA, Hasserjian RP, Le Beau MM, Orazi A, and Siebert R, Editors. IARC Press: Lyon, France, p129-171.
Notes
*Primary authors will typically be those that initially create and complete the content of a page. If a subsequent user modifies the content and feels the effort put forth is of high enough significance to warrant listing in the authorship section, please contact the CCGA coordinators (contact information provided on the homepage). Additional global feedback or concerns are also welcome.
*The hierarchical tumour classification structure displayed on this page is reproduced from the WHO Classification of Tumours with permission from the copyright holder, ©International Agency for Research on Cancer.