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

Li, Xiumei, MD*; Shi, Zhenshan, MD*; You, Ruixiong, MD*; Li, Yueming, MD*; Cao, Dairong, MD*; Lin, Renjie, MD; Huang, Xinming, MD

Journal of Computer Assisted Tomography: May/June 2018 - Volume 42 - Issue 3 - p 399–404
doi: 10.1097/RCT.0000000000000700
Abdominal Imaging

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.

From the *Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou;

Department of Radiology, Fuding Hospital; and

Department of Radiology, Union Hospital of Fujian Medical University, Fujian, China.

Received for publication October 20, 2017; accepted October 23, 2017.

Correspondence to: Dairong Cao, MD, Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Rd, Fuzhou, 350005, Fujian, China (e-mail: 2375530372@qq.com); Yueming Li, MD, Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Rd, Fuzhou, 350005, Fujian, China (e-mail: 13960825028@163.com).

Xiumei Li and Zhenshan Shi contributed equally to this study.

This work was supported by grants of Fujian provincial science and Technology Department (Grant No. 2016Y0039), the Health and Planning Committee of Fujian Province (Grant No. 2016013), Fujian provincial department of Science and Technology (Grant No. 2015J01450) and the Health and Planning Committee of Fujian Province (Grant No. 2017-CX-27).

The authors declare no conflict of interest.

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