Follicular Dendritic Cell Tumor of the Mesentery

Follicular dendritic cell (FDC) tumor is an exceedingly rare malignant neoplasm and occurs mainly in the cervical lymph nodes. We report a mesenteric FDC tumor occurring in a 66-year-old female, that manifested with intraabdominal multifocal recurrence 7 years after resection of the primary tumor. Histologically, both primary and recurrent tumors were composed of oval to spindle cells with paley eosinophilic cytoplasms, indistinct cell borders, round to elongated nuclei with clear or finely dispersed chromatin, and medium to large nucleoli. Characteristically, the tumor cells were growing in sheets, fascicles, and sometimes in whorls and a storiform pattern. In addition, focal necrosis, nuclear pleomorphism and abnormal mitoses were also observed. The neoplastic cells were intimately admixed with small lymphocytes. The diagnosis was confirmed by positive immunoreactivity with CD21 and CD35 antibodies and by ultrastructural demonstration of convoluted interdigitating cell processes connected by scattered desmosome-like junctions. Although our case showed a low proliferative activity evaluated by MIB-1, multifocal recurrence has occurred. The clinicopathologic features and differential diagnosis of FDC tumors are discussed with the review of the literature.