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Table 2 Spindle cell proliferations with inflammatory infiltrate: differential diagnoses

From: Inflammatory pseudotumor-like follicular dendritic cell tumor: an underdiagnosed neoplasia

Mean age (y) M:F ratio Symptoms Preferred sites Markers Clinical outcome
Inflammatory pseudotumor
Middle age to elderly; no gender predilection reported for lymph node; 5:3 female predominance for splenic cases (Ma et al., 2013) Variable: no symptoms; previous signs of infectious process; presence of general symptoms (ca. 60%) Lymph nodes and spleen more common; may be extranodal May be positive: CD68, smooth muscle actin;
Negative: ALK and dendritic cell markers; microorganisms may be found (mycobacteria, lues, fungi, EBV more frequent in spleen and liver)
Favorable after treatment; no recurrence or distant metastases
Inflammatory myofibroblastic tumor
Around 30 years;
Children and young adults preferred;
M equal to F
15–30% general symptoms: fever, weight loss, anemia, thrombocytosis, hipergammaglobulinemia, elevated erythrocyte sedimentation rate Lung, soft tissue of abdomen, pelvis and retroperitoneum Spindle cells frequently positive for smooth muscle actin; ALK positive ~50–60%;
May be EBV+; Negative for CD21, CD23, CD35, CNA42
Local recurrence (10–25%); distant metastases (<5%)
Inflammatory pseudotumor-like follicular dendritic cell tumor
Around 40y;Female predominate Assymptomatic, abdominal pain, fadigue Spleen, liver or both Positive for CD21, CD23, CD35, CNA42; Negative for ALK; EBV+ Local recurrence and distant metastases less frequent than other FDCT (>40% recurrence and >25% metastases lung, lymph node, liver)