Inflammatory pseudotumor-like follicular dendritic cell sarcoma of the liver with hepatic lymphoma history: a case report and literature review

Abstract

BackgroundInflammatory pseudotumor (IPT)-like follicular dendritic cell (FDC) sarcoma of the liver is very rare and mostly occurs in females. Up to now, 19 cases were reported in the English literature. Surgical resection remains the preferred method for the management of this kind of tumor. Case presentationWe reported a case of a 47-year-old male patient who had hepatitis B virus infection history and presented with up-abdominal discomfort. He underwent liver resection of segment VII for hepatic non-hodgkin lymphoma (B-cell lymphoma) 19 years ago. Serum alpha fetoprotein was normal. Imaging studies revealed a well-circumscribed, solid mass in the right hepatic lobe and was diagnosed as HCC or hepatic lymphoma. Right hemihepatectomy was performed and the patient was disease free after a follow-up of 20 months. Histological feature showed a mixture of chronic inflammatory cells and variable amounts of spindle cells. Immunohistochemical studies demonstrated that all the tumor cells showed strong nuclear in situ labeling for EBV-encoded small RNAs (EBER) and strongly positive staining with CD21 and CD35. A diagnosis of hepatic IPT-like FDC sarcoma was rendered. The coexistence of IPT-like sarcoma and non-Hodgkin’s lymphoma in same patient is extremely rare. He remains disease-free more than 40 months after surgical resection.ConclusionTo our knowledge, this is the first report to demonstrate hepatic IPT-like FDC sarcoma in a patient with primary hepatic non-hodgkin lymphoma history. Complete surgical resection should be pursued.