Follicular Dendritic Cell Tumor of the Abdominal Lymph Node attached to the Pancreas Body

Yasoo Sugiura, Fumiki Toriumi, Hiroyuki Toeda, Takayuki Hara, Tomoyoshi Koshida, Yoshihiro Imadu, Hidetoshi Akamatsu and Kiyoshi Mukai*

Department of Surgery, Tokyo Saiseikai Central Hospital
Department of Pathology, Tokyo Medical University*

A 47-year-old man administered imatinib mesylate for chronic myelogenous leukemia (CML) since 1999 was found in an abdominal ultrasound gastrointestinal series medical check to have a mass in February 2007. Gastrofiberscopy and dynamic CT showed a well-cirumscribed solid mass 8 cm in diameter between the lesser curvature of the stomach and the pancreatic body. The mass contained a calcificated foci lesion and was enhanced heterogeneously. Laparotomy showed a hard, well-demarcated mass with a thick fibrous capsule fixed to the anterior surface of the pancreatic body necessitating distal pancreatectomy and splenectomy. Histologically, the mass was encapsulated and adhered to the pancreatic capsule. The mass was a lymph node containing bundles and nodules of spindle cells without significant atypia or mitosis. Immuunohistochemically tumor cells were positive for CD21, EMA, and CD68 and negative for CD1a and S-100 protein. The tumor was diagnosed as follicular dendritic cell (FDC) tumor arising from the abdominal lymph node. We here report about the rare case of the primary abdominal FDC tumor respecting imaging diagnosis.

Key words
follicular dendritic cell tumor, imatinib, chronic myelogenous leukemia

Reprint requests
Fumiki Toriumi Department of Surgery, Tokyo Saiseikai Central Hospital
1-4-17 Mita, Minato-ku, 108-0073 JAPAN

Accepted
September 24, 2008

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