Follicular dendritic cell sarcoma presenting as a neck mass, arising in background of castleman’s disease in cervical lymph nodes

Abstract

Follicular dendritic cell sarcoma is a rare tumour of intermediate malignant potential. Hyaline vascular Castleman's disease is known to be a precursor lesion in a subset of patients. We present a case of a 39-year-old female who presented with a right neck lump. CT scan showed a 9 cm mass in the right neck extending into the superior mediastinum. Open biopsy showed the lesion to be composed of spindle cells arranged in a fascicular to storiform pattern, with interspersed lymphocytes. Immunohisto-chemistry showed staining for CD21 and CD23, consistent with the diagnosis of follicular dendritic cell sarcoma. The patient underwent subsequent surgical resection. Hyaline vascular Castle-man's disease was found in the adjacent cervical lymph nodes.