Skip to main content

Advertisement

SpringerLink
Log in

Interdigitating dendritic cell tumor with breast and cervical lymph-node involvement: a case report and review of the literature

  • Case Report
  • Published:
Virchows Archiv Aims and scope Submit manuscript

Abstract

Interdigitating dendritic cell tumor (IDCT) is an extremely rare malignancy. It occurs primarily in lymph nodes, but extranodal involvement has also been reported. A 38-year-old woman with IDCT with breast and cervical lymph-node involvement is reported in this paper. To our knowledge, this is the first case of IDCT originating from the breast. In the breast and lymph node, the tumor displayed diffuse sheets, fascicles and storiform growth pattern. It was composed of oval to spindle cells with pale to eosinophilic cytoplasm, ill-defined cell outlines, oval nuclei with vesicular chromatin and prominent eosinophilic nucleoli. Mitotic activity was three per ten high-power fields. The neoplastic cells were intermingled with small mature lymphocytes and plasma cells. Immunohistochemical studies showed that the tumor cells were strongly and diffusely positive for vimentin, CD68, S-100 protein, CD45/leukocyte common antigen and fascin and focally positive for lysozyme, alpha-1 antitrypsin and CD4. Ki-67 labeling index was 10%. The patient was treated with combined therapeutic approaches, including surgery, radiotherapy and chemotherapy. IDCT has the potential for an aggressive clinical course. However, 32 months after the initial diagnosis, the patient is still alive and being followed with a stable tumor burden.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Andriko JW, Kaldiian EP, Tsokos M, Abbondanzo SL, Jaffe ES (1998) Reticulum cell neoplasms of lymph nodes: a clinicopathologic study of 11 cases with recognition of a new subtype derived from fibroblastic reticular cells. Am J Surg Pathol 22:1048–1058

    Article  CAS  PubMed  Google Scholar 

  2. Banner B, Beauchamp ML, Liepman M, Woda BA (1997) Interdigitating reticulum-cell sarcoma of the intestine: a case report and review of the literature. Diagn Cytopathol 17:216–222

    Google Scholar 

  3. Barwell N, Howatson R, Jackson R, Johnson A, Jarrett RF, Cook G (2004) Interdigitating dendritic cell sarcoma of salivary gland associated lymphoid tissue not associated with HHV-8 or EBV infection. J Clin Pathol 57:87–89

    Google Scholar 

  4. Chan WC, Zaatari G (1986) Lymph node interdigitating reticulum cell sarcoma. Am J Clin Pathol 85:739–744

    Google Scholar 

  5. Daum GS, Liepman M, Woda BA (1985) Dendritic cell phenotype in localized malignant histiocytosis of the small intestine. Arch Pathol Lab Med 109:647–650

    Google Scholar 

  6. Feltkamp CA, van Heerde P, Feltkamp-Vroom TM, Koudstaal J (1981) A malignant tumour arising from interdigitating cells: light microscopical, ultrastructural, immuno- and enzyme-histochemical characteristics. Virchows Arch 393:183–192

    Google Scholar 

  7. Fisher C, Magnusson B, Hardarson S, Smith ME (1999) Myxoid variant of follicular cell sarcoma arising in the breast. Ann Diagn Pathol 3:92–98

    Google Scholar 

  8. Fonseca R, Yamakawa M, Nakamura S, van Heerde P, Miettinen M, Shek TWK, Jensen OM, Rousselet MC, Tefferi A (1998) Follicular dendritic cell sarcoma and interdigitating reticulum cell sarcoma: a review. Am J Hematol 59:161–167

    Google Scholar 

  9. Foucar K, Foucar E (1990) The mononuclear phagocyte and immunoregulatory effector (M-PIRE) system: evolving concepts. Semin Diagn Pathol 7:4–18

    Google Scholar 

  10. Friess A (1976) Interdigitating reticulum cells in the popliteal lymph node of the rat: an ultrastructural and cytochemical study. Cell Tissue Res 170:43–60

    Google Scholar 

  11. Gaertner EM, Tsokos M, Derringer GA, Neuhauser TS, Arciero C, Andriko JW (2001) Interdigitating dendritic cell sarcoma: a report of four cases and review of the literature. Am J Clin Pathol 115:589–597

    Article  CAS  PubMed  Google Scholar 

  12. Grogg KL, Lae ME, Kurtin PJ, Macon WR (2004) Clusterin expression distinguishes follicular dendritic cell tumors from other dendritic cell neoplasms. Am J Surg Pathol 28:988–998

    Google Scholar 

  13. Hammar SP, Rudolph RH, Bockus DE, Remington FL (1991) Interdigitating reticulum cell sarcoma with unusual features. Ultrastruct Pathol 15:631–645

    Google Scholar 

  14. Horschowski N, Guitard AM, Arnoux I, Michel G, Thuret I, George F, Perrimond H (1993) Interdigitating cell sarcoma: occurrence during incomplete remission of a lymphoblastic lymphoma. Pathol Biol (Paris) 41:255–259

    Google Scholar 

  15. Hui PK, Feller AC, Kaiserling H et al (1987) Skin tumour of T accessory cells (interdigitating reticulum cells) with high content of T lymphocytes. Am J Dermatopathol 9:129–137

    Google Scholar 

  16. Jaffe ES (2001) Histiocytic and dendritic cell neoplasms. In: Jaffe ES, Harris NL, Stein H, Vardiman JW (eds) Tumours of haematopoietic and lymphoid tissues. IARC Press, Lyon pp 284–285

    Google Scholar 

  17. Kawachi K, Nakatani Y, Inayama Y, Kawano N, Toda N, Misugi K (2002) Interdigitating dendritic cell sarcoma of the spleen: report of a case with a review of the literature. Am J Surg Pathol 26:530–537

    Google Scholar 

  18. Lennert K, Mohri N (1978) Histopathology and diagnosis of non-Hodgkin’s lymphomas. In: Vehrlinger E (ed) Malignant lymphomas other than Hodgkin’s disease. Springer, Berlin Heidelberg New York, pp 448

    Google Scholar 

  19. Liu SM, Huang P-H, Liu JM (1998) Interdigitating reticulum cell tumor of lymph node: a case report and literature review. Pathol Int 48:974–980

    Google Scholar 

  20. Luk ISC, Shek TWH, Tang VWL, Ng WF (1999) Interdigitating dendritic cell tumor of the testis: a novel testicular spindle cell neoplasm. Am J Surg Pathol 23:1141–1148

    Google Scholar 

  21. Miettenen M, Fletcher CDM, Lasota J (1993) True histiocytic lymphoma of the small intestine: analysis of two S-100 protein-positive cases with features of interdigitating reticulum cell sarcoma. Am J Clin Pathol 118:285–292

    Google Scholar 

  22. Nakamura S, Hara K, Suchi T, Ito M, Ikeda H, Nagahama M, Nakayama A, Nakagawa A, Kaneshima H, Asai J (1988) Interdigitating cell sarcoma. A morphologic, immunohistologic and enzyme-histochemical study. Cancer 61:562–568

    Google Scholar 

  23. Nakamura S, Koshikawa T, Kitoh K, Nakayama A, Yamakawa M, Imai Y, Ishii K, Fujita M, Suchi T (1994) Interdigitating cell sarcoma: a morphologic and immunologic study of lymph node lesions in four cases. Pathol Int 44:374–386

    Google Scholar 

  24. Olnes MJ, Nicol T, Duncan M, Bohlman M, Erlich R (2002) Interdigitating dendritic cell sarcoma: a rare malignancy responsive to ABVD chemotherapy. Leuk Lymphoma 43:817–821

    Article  CAS  PubMed  Google Scholar 

  25. Pileri SA, Grogan TM, Harris NL, Banks P, Campo E, Chan JKC, Favera RD, Delsol G, De Wolf-Peeters C, Falini B, Gascoyne RD, Gaulard P, Gatter KC, Isaacson PG, Jaffe ES, Kluin P, Knowles DM, Mason DY, Mori S, Müller-Hermelink H-K, Piris MA, Ralfkiaer E, Stein H, Su I-J, Warnke RA, Weis LM (2002) Tumours of histiocyte and accessory dendritic cells: an immunohistochemical approach to classification from the International Lymphoma Study Group based on 61 cases. Histopathology 41:1–29

    Article  CAS  Google Scholar 

  26. Pillay K, Solomon R, Daubenton JD, Sinclair-Smith CC (2004) Interdigitating dendritic cell sarcoma: a report of four pediatric cases and review of the literature. Histopathology 44:283–291

    Google Scholar 

  27. Pruneri G, Masullo M, Renne G, Taccagni G, Manzotti M, Luini A, Viale G (2002) Follicular dendritic cell sarcoma of the breast. Virchows Arch 441:194–199

    Google Scholar 

  28. Rabkin MS, Kjeldsberg CR, Hammond ME, Wittwer CT, Nathwani B (1988) Clinical, ultrastructural, immunohistochemical and DNA content analysis of lymphomas having features of interdigitating reticulum cells. Cancer 61:1594–1601

    Google Scholar 

  29. Rousselet M-C, François S, Croue A, Maigre M, Saint-Andre J-P, Ifrah N (1994) A lymph node interdigitating reticulum cell sarcoma. Arch Pathol Lab Med 118:183–188

    Google Scholar 

  30. Salisbury JR, Ramsay AD, Isaacson PG (1985) Histiocytic lymphoma: a report of a case with unusual phenotype. J Pathol 146:99–106

    Google Scholar 

  31. Stenman R, Pack M, Inaba K (1997) Dendritic cells in the T-cell areas of lymphoid organs. Immunol Rev 156:25–37

    Google Scholar 

  32. Turner RR, Wood GS, BekColby TV, Horning SJ, Warnke RA (1984) Histiocytic malignancies: morphologic, immunologic and enzymatic heterogeneity. Am J Surg Pathol 8:485–500

    Google Scholar 

  33. van den Oord JJ, de Wolf-Peeters C, de Vos R, Thomas J, Desmet VJ (1986) Sarcoma arising from interdigitating reticulum cells: report of a case, studied with light and electron microscopy, and enzyme- and immunohistochemistry. Histopathology 10:509–523

    Google Scholar 

  34. Vasef MA, Zaatari GS, Chan WC, Sun NCJ, Weiss LM, Brynes RK (1995) Dendritic cell tumours associated with low grade B-cell malignancies: report of three cases. Am J Clin Pathol 104:696–701

    Google Scholar 

  35. Weiss LM, Berry GJ, Dorfman RF, Banks P, Kaiserling E, Curtis J, Rosai J, Warnke RA (1990) Spindle cell neoplasm of lymph nodes of probable reticulum cell lineage: true reticulum cell sarcoma? Am J Surg Pathol 14:405–414

    Google Scholar 

  36. Weiss LM (2001) Histiocytic and dendritic cell proliferations. In: Knowles DM (ed) Neoplastic hematopathology. Lippincott, Williams and Wilkins, Philadelphia, pp 1815–1846

    Google Scholar 

  37. Wright-Brown V, McClain KL, Talpaz M, Ordonez N, Estrov Z (1997) Physiology and pathophysiology of dendritic cells. Hum Pathol 28:563–579

    Google Scholar 

  38. Yamakawa M, Matsuda M, Imai Y, Arai S, Harada K, Sato T (1992) Lymph node interdigitating cell sarcoma: a case report. Am J Clin Pathol 97:139–146

    Google Scholar 

  39. Ylagan LR, Bartlett NL, Kraus M (2003) Interdigitating dendritic reticulum cell tumor of lymph nodes: case report with differential diagnostic considerations. Diagn Cytopathol 28:278–281

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Gazi University Medical School, Ankara, Turkey

    Ömer Uluoğlu & Nalan Akyürek

  2. Department of Medical Oncology, Gazi University Medical School, Ankara, Turkey

    Aytuğ Üner & Uğur Coşkun

  3. Department of Radiology, Gazi University Medical School, Ankara, Turkey

    Ayşegul Özdemir

  4. Department of Nuclear Medicine, Gazi University Medical School, Ankara, Turkey

    Nahide Gökçora

  5. S. Ozdemir Mah. Percem Sok. No: 44/20, 06460, Dikmen-Ankara, Turkey

    Nalan Akyürek

Authors
  1. Ömer Uluoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nalan Akyürek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aytuğ Üner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Uğur Coşkun
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ayşegul Özdemir
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nahide Gökçora
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nalan Akyürek.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Uluoğlu, Ö., Akyürek, N., Üner, A. et al. Interdigitating dendritic cell tumor with breast and cervical lymph-node involvement: a case report and review of the literature. Virchows Arch 446, 546–554 (2005). https://doi.org/10.1007/s00428-005-1209-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00428-005-1209-3

Keywords

Search

Navigation