Inflammatory Pseudotumor-Like Follicular Dendritic Cell Sarcoma of the Spleen: Computed Tomography Imaging Characteristics in 5 Patients

J Comput Assist Tomogr. 2018 May/Jun;42(3):399-404. doi: 10.1097/RCT.0000000000000700.

Abstract

Objectives: The purpose of this study was to retrospectively review the computed tomography (CT) and clinicopathological characteristics of inflammatory pseudotumor (IPT)-like follicular dendritic cell sarcoma (FDCS) of the spleen in 5 patients.

Methods: Clinical, pathologic, and CT imaging findings of 5 patients with IPT-like FDCS of the spleen were reviewed and analyzed. Computed tomography imaging and pathologic features were compared.

Results: Abdominal unenhanced CT revealed a well-defined hypodense mass in the spleen with complex internal architecture with focal necrosis and/or speckle-strip calcification. On postcontrast CT, slightly delayed enhancement was observed in 5 cases. Four patients had a normalized spleen. The fourth patient had lung metastasis. The fifth patient had 2 relatively small lesions as well as metastases to the spine.

Conclusions: Computed tomography imaging features of IPT-like FDCS of the spleen are distinctly different from other hypovascular splenic neoplasm; however, the definitive diagnosis requires further confirmation with needle biopsy or surgery. Inflammatory pseudotumor-like FDCS of the spleen should be suggested by using the CT imaging features of the splenic mass with evidence of metastatic disease.

MeSH terms

  • Adult
  • Dendritic Cell Sarcoma, Follicular / diagnostic imaging*
  • Female
  • Granuloma, Plasma Cell / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Retrospective Studies
  • Spleen / diagnostic imaging
  • Splenic Neoplasms / diagnostic imaging*
  • Tomography, X-Ray Computed / methods*