%0 Journal Article
%T A Rare Case of Interdigitating Dendritic Cell Sarcoma in the Nasal Cavity
%A Eun Jung Lee
%A Dong Woo Hyun
%A Hyung-Ju Cho
%A Jeung-Gweon Lee
%J Case Reports in Otolaryngology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/913157
%X Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare neoplasm that mainly arises from the lymphoid tissues of the immune system. Although this neoplasm typically occurs anywhere along the lymph nodes, it can also be found at extranodal sites, especially in the head and neck. We experienced a rare case of extranodal IDCS in the nasal cavity, a location that has not been previously reported. A 73-year-old woman presented with a polyp-like mass in the nasal cavity and underwent endoscopic sinus surgery. A histologic study confirmed the mass as IDCS by immunohistochemistry with S-100 antibody, and postoperative adjuvant radiotherapy was administered. Although the incidence is extremely rare, this case suggests that extranodal IDCS should be considered in the differential diagnosis of nasal cavity masses. 1. Introduction Tumors arising from dendritic cells, such as follicular dendritic cell sarcoma/tumor (FDCS) and interdigitating dendritic cell sarcoma/tumor (IDCS) (WHO), are extremely rare [1, 2]. Although most dendritic cell sarcomas arise in the lymph nodes of the cervical, mediastinal, or axillary regions, approximately one-third of the cases involve extranodal sites such as the spleen, small intestine, skin, testis, ovary, urinary bladder, and tonsils [2]. Among extranodal sites, the occurrence in the head and neck area is especially low, and only eight cases in oral cavity have been reported [3¨C6]. We experienced a case of IDCS of the nasal cavity that was successfully treated by endoscopic surgery with postoperative radiotherapy. Immunohistochemistry with S-100, which is an interdigitating dendritic cell marker, is essential for the confirmation of diagnosis. Although the incidence is extremely rare in the head and neck, the possibility of extranodal IDCS warrants full consideration upon differential diagnosis. 2. Case Report A 73-year-old woman visited our clinic and presented with a nasal obstruction and frequent blood-tinged crust that had persisted for 4 months. Initial endoscopic findings revealed a soft and fungating mass, which appeared as a nasal polyp in the middle meatus of the right nasal cavity. The mass was partially attached to the septum and was more than 1£¿cm long in its greatest dimension. Although it had no bleeding tendencies, hyperemic mucosa and some blood clots were noted around the mass. Paranasal sinus computed tomography (PNS CT) revealed a 2.2£¿cm polyp in the right middle meatus without sinusitis (Figure 1(a)). The mass had well-defined margins that were heterogeneously iso-intense on PNS CT. On axial images,
%U http://www.hindawi.com/journals/criot/2013/913157/