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Fig. 4.54 Follicular dendritic cell sarcoma / tumour of oral cavity and oropharynx. A This palatal tumour invades in pushing fronts. The main tumour is seen in the right. Smooth-contoured nodules (upper field) invade the adjacent normal structures. B Uncommon nodular growth pattern, recapitulating the ability of follicular dendritic cells to form follicles. C Typical storiform pattern, accompanied by a sprinkling of lymphocytes. D This tumour consists of spindle cells with elongated nuclei, fine chromatin and small distinct nucleoli. Some cells have ill-defined cell borders, while others exhibit well-defined borders. E The tumour cell nuclei often appear haphazardly distributed, with some focal clustering. A few multinucleated tumour cells are also evident. The cytoplasm exhibits a fibrillary quality. F This example, composed of plump ovoid cells, shows a moderate degree of nuclear atypia and pleomorphism. Nucleoli are prominent.

Fig. 4.54 Follicular dendritic cell sarcoma / tumour of oral cavity and oropharynx. A This palatal tumour invades in pushing fronts. The main tumour is seen in the right. Smooth-contoured nodules (upper field) invade the adjacent normal structures. B Uncommon nodular growth pattern, recapitulating the ability of follicular dendritic cells to form follicles. C Typical storiform pattern, accompanied by a sprinkling of lymphocytes. D This tumour consists of spindle cells with elongated nuclei, fine chromatin and small distinct nucleoli. Some cells have ill-defined cell borders, while others exhibit well-defined borders. E The tumour cell nuclei often appear haphazardly distributed, with some focal clustering. A few multinucleated tumour cells are also evident. The cytoplasm exhibits a fibrillary quality. F This example, composed of plump ovoid cells, shows a moderate degree of nuclear atypia and pleomorphism. Nucleoli are prominent.

Fig. 4.55 Follicular dendritic cell sarcoma/tumour of the oral cavity. The surface epithelium is intact. This tumour shows partial involvement of the tonsil (left field).

work pattern is highlighted. Cytokeratin is negative. A proportion of cases express epithelial membrane antigen or muscle-specific actin. Occasional cases can weakly express the pan-B marker CD20 {2043}. Ultrastructurally, the tumour cells possess interdigitating long slender cytoplasmic processes and intercellular desmosome junctions. Differential diagnoses include soft tissue sarcoma, poorly differentiated carcinoma, meningioma, and malignant melanoma.

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