Interdigitating dendritic cell sarcoma of the ileum recurred in multiple lymph nodes and duodenum three years after operation without chemotherapy.
Neoplasms derived from interdigitating dendritic cell are extremely rare. Here we describe a case of a 47-year-old man with interdigitating dendritic cell sarcoma (IDCS) in the ileum. He was admitted to a hospital due to ileus. The ileal tumor, measuring 2cm, was detected and resected with regional lymphadenectomy. At that time, a pathologic diagnosis of malignant peripheral nerve sheath tumor was made. The patient, who was not treated with chemotherapy, showed no signs of recurrence. After three years, we detected cervical lymphadenopathy and multiple duodenal masses in the patient in our hospital. Oval to spindle-shaped atypical cells, which resembled ileal tumor cells, infiltrated into the lymph node and duodenum. Immunohistochemical staining of these three lesions revealed positivity of S100 protein and several macrophage-related antigens. Based on the histologic and immunohistochemical analysis, the histopathologic diagnosis of IDCS was confirmed. To our knowledge, five cases of IDCS arising in the intestinal tract have been reported to date, and only one case, treated with both surgery and chemotherapy, led to remission. This is the first case that has a comparatively favorable prognosis without chemotherapy after surgery.
Ishihara
Sonoko
S
Department of Surgical Pathology, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto 860-8556, Japan. snk0211@fc.kuh.kumamoto-u.ac.jp
Honda
Yumi
Y
Asato
Tsuguharu
T
Nonaka
Michiyasu
M
Nakagawa
Shigeki
S
Hirashima
Kotaro
K
Hayashi
Naoko
N
Baba
Hideo
H
Iyama
Ken-ichi
K
D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D054739:Dendritic Cell Sarcoma, Interdigitating / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D003951:Diagnostic Errors; D013505:Digestive System Surgical Procedures; D004379:Duodenal Neoplasms / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007078:Ileal Neoplasms / Q000473:pathology* / Q000601:surgery; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D018317:Nerve Sheath Neoplasms / Q000473:pathology
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor