EBV-positive inflammatory follicular dendritic cell sarcoma occurring in different organs: a case report and literature review

BackgroundEpstein-Barr virus (EBV)-positive inflammatory follicular dendritic cell sarcoma (EBV+ IFDCS) represents a low-grade malignancy arising from the proliferation of follicular dendritic cells. This distinct and rare subtype, characterized by abundant lymphoplasmacytic infiltration, is closely...

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Main Authors: Wenhua Bai, Chunfang Hu, Zheng Zhu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1603496/full
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author Wenhua Bai
Chunfang Hu
Zheng Zhu
author_facet Wenhua Bai
Chunfang Hu
Zheng Zhu
author_sort Wenhua Bai
collection DOAJ
description BackgroundEpstein-Barr virus (EBV)-positive inflammatory follicular dendritic cell sarcoma (EBV+ IFDCS) represents a low-grade malignancy arising from the proliferation of follicular dendritic cells. This distinct and rare subtype, characterized by abundant lymphoplasmacytic infiltration, is closely linked to EBV infection and is seldom encountered in clinical practice.MethodsPresented here are three cases of primary EBV+ IFDCS, occurring in the liver and spleen. This study systematically analyzed the clinical presentations, radiological features, and pathological characteristics of our cases. Additionally, we conducted a comprehensive review of the respective characteristics documented in the existing literature.ResultsWe present three cases of EBV+ IFDCS, with lesions localized to the spleen (n=2) and liver (n=1). Notably, only one patient developed clinical symptoms secondary to splenic mass rupture and post-embolization sequelae, while the remaining cases were identified incidentally without associated symptomatology. All three patients underwent preoperative contrast-enhanced magnetic resonance imaging (CT) scans demonstrating solitary, well-circumscribed round masses/nodules. The two splenic lesions exhibited necrotic-cystic degeneration and one displayed a capsule, with absence of calcification in all cases. Tumor parenchyma showed mild arterial-phase enhancement and partial delayed-phase washout. The two splenic cases underwent additional magnetic resonance imaging (MRI) evaluation, revealing restricted diffusion in the solid tumor components and apparent diffusion coefficient (ADC) values comparable to the surrounding splenic parenchyma. Complete surgical excision was performed in all patients, and histopathological evaluation confirmed the diagnosis of EBV+ IFDCS through immunohistochemical analysis. As of the latest follow-up, all three patients are alive.ConclusionEBV+ IFDCS is a rare condition that primarily arises in the liver and spleen, with prognosis varying among patients with primary tumors in different organs. This study presents three cases of EBV+ IFDCS that occurred in diverse anatomical locations, examines their clinical, radiological, pathological features and differential diagnoses, and aims to deepen the understanding of clinicians and radiologists regarding this form of Mesenchymal dendritic cell neoplasm.
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spelling doaj-art-cbb8082f7aae45cc8c0dee881b2f9e932025-07-31T11:47:40ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-07-011510.3389/fonc.2025.16034961603496EBV-positive inflammatory follicular dendritic cell sarcoma occurring in different organs: a case report and literature reviewWenhua Bai0Chunfang Hu1Zheng Zhu2Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaBackgroundEpstein-Barr virus (EBV)-positive inflammatory follicular dendritic cell sarcoma (EBV+ IFDCS) represents a low-grade malignancy arising from the proliferation of follicular dendritic cells. This distinct and rare subtype, characterized by abundant lymphoplasmacytic infiltration, is closely linked to EBV infection and is seldom encountered in clinical practice.MethodsPresented here are three cases of primary EBV+ IFDCS, occurring in the liver and spleen. This study systematically analyzed the clinical presentations, radiological features, and pathological characteristics of our cases. Additionally, we conducted a comprehensive review of the respective characteristics documented in the existing literature.ResultsWe present three cases of EBV+ IFDCS, with lesions localized to the spleen (n=2) and liver (n=1). Notably, only one patient developed clinical symptoms secondary to splenic mass rupture and post-embolization sequelae, while the remaining cases were identified incidentally without associated symptomatology. All three patients underwent preoperative contrast-enhanced magnetic resonance imaging (CT) scans demonstrating solitary, well-circumscribed round masses/nodules. The two splenic lesions exhibited necrotic-cystic degeneration and one displayed a capsule, with absence of calcification in all cases. Tumor parenchyma showed mild arterial-phase enhancement and partial delayed-phase washout. The two splenic cases underwent additional magnetic resonance imaging (MRI) evaluation, revealing restricted diffusion in the solid tumor components and apparent diffusion coefficient (ADC) values comparable to the surrounding splenic parenchyma. Complete surgical excision was performed in all patients, and histopathological evaluation confirmed the diagnosis of EBV+ IFDCS through immunohistochemical analysis. As of the latest follow-up, all three patients are alive.ConclusionEBV+ IFDCS is a rare condition that primarily arises in the liver and spleen, with prognosis varying among patients with primary tumors in different organs. This study presents three cases of EBV+ IFDCS that occurred in diverse anatomical locations, examines their clinical, radiological, pathological features and differential diagnoses, and aims to deepen the understanding of clinicians and radiologists regarding this form of Mesenchymal dendritic cell neoplasm.https://www.frontiersin.org/articles/10.3389/fonc.2025.1603496/fullEBV-positive inflammatory follicular dendritic cell sarcomaEpstein-Barr viruscomputed tomographymagnetic resonance imagingcase report
spellingShingle Wenhua Bai
Chunfang Hu
Zheng Zhu
EBV-positive inflammatory follicular dendritic cell sarcoma occurring in different organs: a case report and literature review
Frontiers in Oncology
EBV-positive inflammatory follicular dendritic cell sarcoma
Epstein-Barr virus
computed tomography
magnetic resonance imaging
case report
title EBV-positive inflammatory follicular dendritic cell sarcoma occurring in different organs: a case report and literature review
title_full EBV-positive inflammatory follicular dendritic cell sarcoma occurring in different organs: a case report and literature review
title_fullStr EBV-positive inflammatory follicular dendritic cell sarcoma occurring in different organs: a case report and literature review
title_full_unstemmed EBV-positive inflammatory follicular dendritic cell sarcoma occurring in different organs: a case report and literature review
title_short EBV-positive inflammatory follicular dendritic cell sarcoma occurring in different organs: a case report and literature review
title_sort ebv positive inflammatory follicular dendritic cell sarcoma occurring in different organs a case report and literature review
topic EBV-positive inflammatory follicular dendritic cell sarcoma
Epstein-Barr virus
computed tomography
magnetic resonance imaging
case report
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1603496/full
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AT zhengzhu ebvpositiveinflammatoryfolliculardendriticcellsarcomaoccurringindifferentorgansacasereportandliteraturereview