Journal of Experimental & Clinical Cancer Research 2008, 27:33 http://www.jeccr.com/content/27/1/33 been an increasing interest in this neoplasm due to avail- ability of specific antibodies to confirm FDC lineage and thus wider recognition. Almost all patients have been adults, with a median age of 40 years and with a slight female predominance [2]. Most patients present with cervical or axillary lymphoadenopa- thy but extranodal sites, including oral cavity, tonsil, gas- trointestinal tract, soft tissue [3] and breast, may occur in almost one third of the patients. We report a case of nodal FDC sarcoma who was success- fully diagnosed and treated with surgery and chemother- apy, comprehending PEG-liposomal doxorubicin. Methods A 49 year old woman presented at our Institute with an enlarged (2 cm), hard, mobile lymph node of the right cervical area that had been present for about 3 months. An ultrasound examination of the thyroid gland showed two nodules of 12 × 8 mm and 6 × 6 mm and a fine needle aspiration cytology was benign. The patient underwent a right neck dissection with complete excision of lymph node and multiple biopsies of nasopharynx, pyriform sinus and postcricoid area. The fiberlaryngoscopic and oralpharyngealscopic evalua- tions were negative for extensive or focal malignancies. Histopathologic findings The 2 cm lymph node was partially substituted from a proliferation of oval-to-spindle cells with vesicular or stip- pled chromatin and oval to spindle shaped nuclei. The cells had scant eosinophilic cytoplasm with indistinct bor- der and the mitotic rate was low (Figure 1). The follicular areas of lymph node were disappeared but residual T lymphoid tissue was generally present. Immu- nologically, the tumor cells showed a close resemblance to the normal follicular dendritic cells with consistent expression of CD21 [C3d complement receptor] (Figure 2) and CD23 (Figure 3). Tumor cells were negative for cytokeratin, CD45, CD20, CD3, CD30, CD68, CD35 and CD1a; Ki-67 was positive in about 15% of the cells. The final diagnosis was a follicular dendritic cell sarcoma. Other tissue specimens from nasopharynx, pyriform sinus and postcricoid area were free from malignant involve- ment. Clinical data Routine hematological parameters showed hemoglobin 13.1 g/dl, WBC 5.9 × 109/l (53% polymorphonuclear cells, 39% lymphocytes, 8% monocytes), platelets 214 × 109/l, all the other biochemical parameters were normal. ePoFmlavioigratnotul-igatraiolcets-ersu1dapbtisnetuditclueletcio,esnllcsoawnftliytehmovpseihnsoincpouhdlaielricforcorymstotiaplppalsremodlicfaehnrrdaotwmioianthtionlfo,w Partial substitution of lymph node from a prolifera- tion of oval-to-spindle cells with vesicular or stippled chromatin, elongated nuclei, scant eosinophilic cyto- plasm and with low mitotic rate. H&E, × 400. Hepatitis B and C, HIV serology were negative, EBV serol- ogy showed no IgM antibodies but positivity for IgG anti VCA and IgG anti EBNA. Bone marrow aspiration and trephine yielded a normal hemopoiesis. A total body computed scan was made showing multiple hepatic angiomas (confirmed by MRI scan) and small subpleural fibrocalcific residuals, the rest of the exploration was normal. The patient also under- went an echocardiography that disclosed a good cardiac function with normal ejection fraction. IFmigmuurneo2histochemical staining: Positive staining for CD21 Immunohistochemical staining: Positive staining for CD 21 Page 2 of 4 (page number not for citation purposes)