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Fibroblastic/cytokeratin-positive interstitial reticular cell tumor of the spleen with indolent behavior: a case report with review of the literature

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Abstract

Fibroblastic reticulum cell tumor (FRCT) is a rare dendritic neoplasm arising from fibroblastic reticulum cells (FBRCs) and exhibiting peculiar cytokeratin expression. FRCTs usually involve the lymph nodes, although they can also be encountered in the spleen and soft tissues. FRCTs are composed of mildly atypical spindle or ovoid cells, arranged in loose whorls, which express almost invariably low-weight cytokeratins, smooth muscle actin, and CD68. An admixed lymphoplasmacytic infiltrate is also frequently present in solid organ sites. The clinical picture may vary from very indolent to aggressive disease exhibiting features of malignancy, such as cytological pleomorphism, necrosis, or high mitotic rate and metastatic potential. FRCT is a challenging diagnosis, due to its rarity and deceptive cytokeratin expression. Hereafter, we revise the most recent literature regarding such condition and report the case of an extremely indolent splenic FRCT, with no features of malignancy.

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Acknowledgements

We would like to thank Ms. Elisa De Nanni for her kind contribution to the language editing of the manuscript.

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Authors and Affiliations

  1. Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy

    Carlo Pescia, Gianluca Lopez & Giorgio Alberto Croci

  2. Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano, 20122, Milan, Italy

    Carlo Pescia, Gianluca Lopez & Umberto Gianelli

  3. Unit of Anatomic Pathology, Ospedale San Paolo, ASST Santi Paolo E Carlo, 20122, Milan, Italy

    Umberto Gianelli

Authors
  1. Carlo Pescia
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  2. Gianluca Lopez
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  3. Umberto Gianelli
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  4. Giorgio Alberto Croci
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Contributions

Conceptualization, G.A.C., C.P., G.L..; data curation, G.L., C.P..; formal analysis, C.P., G.L., G.A.C.; investigation, G.A.C., C.P.; methodology, G.L., C.P.; supervision, G.A.C., U.G.; writing—original draft, C.P., and G.L.; writing—review and editing, C.P., G.L., G.A.C., U.G. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Carlo Pescia.

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The study was conducted according to the guidelines of the Declaration of Helsinki and informed consent was obtained from the patient.

Conflict of interest

U.G. received fees from Novartis Farma S.p.A. and Jazz Pharma as a consultant speaker and advisory board. All other authors declare no conflict of interest.

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Pescia, C., Lopez, G., Gianelli, U. et al. Fibroblastic/cytokeratin-positive interstitial reticular cell tumor of the spleen with indolent behavior: a case report with review of the literature. Virchows Arch 482, 1069–1077 (2023). https://doi.org/10.1007/s00428-022-03463-9

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  • DOI: https://doi.org/10.1007/s00428-022-03463-9

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