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Clinical Note |

Interdigitating Dendritic Cell Sarcoma of Cervical Lymph Nodes

Stephen Jo, MD; Michael J. Babb, MD; Raymond L. Hilsinger Jr, MD
Arch Otolaryngol Head Neck Surg. 2006;132(11):1257-1259. doi:10.1001/archotol.132.11.1257.
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Interdigitating dendritic cell sarcoma (IDCS) is a malignant neoplasm that arises from the interdigitating reticular cells of the lymph node. Dendritic cells are a heterogeneous group of antigen-presenting cells that play a major role in innate and adaptive immune responses. Subtypes of dendritic cells include Langerhans cells, interdigitating dendritic cells, follicular dendritic cells, and dermal dendrocytes.1 Interdigitating dendritic cells reside in the T-cell areas of peripheral lymphoid tissue, including the paracortex of lymph node and tonsil, the splenic periarteriolar lymphoid sheaths, and the interfollicular areas of mucosa-associated lymphoid tissue, and are responsible for major histocompatibility complex–restricted stimulation of resting T cells. Interdigitating dendritic cell sarcoma is rare; to our knowledge, only 34 cases have been reported to date.14 Lymphadenopathy is the most common physical finding at presentation, and 42% of cases occur in the head and neck.1,2,4 Otolaryngologists evaluating a head and neck mass should therefore include IDCS in the differential diagnosis.

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Figure 1.

Photomicrograph shows population of normal-appearing lymphocytes (right side) and large oval and polygonal tumor cells (left side) with atypical-appearing nuclei.

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Figure 2.

Photomicrograph shows immunohistochemically stained cells positive for S100 protein.

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