A 46-year-old black woman was admitted in May 2002 due to increased volume in the right axillary region.
She had a history that 17 years ago was operated in the same area of a tumor without specifying its etiology.
Six years ago he had noticed a new increase in volume in the same region with shoulder pain and decreased strength in the upper limb on the same side.
On physical examination, adenopathy was detected in the right axilla of 6 to 7 cm in diameter, hard but not painful.
The rest of the physical examination was normal.
The results of the investigations were as follows: hemoglobin, hematocrit, leucogram, platelets, PT, TPT, glucose, creatinine, protein electrophoresis, all within normal limits.
Direct negative indirect Coombs test, erythrocyte sedimentation rate 42 mm/h.
Hepatitis C and B virus negative.
Chest plaque and abdominal ultrasound were normal.
Lymph node biopsy: total loss of architecture showing predominant angiofollicular hyperplasia with follicles in regression, some with hyperplasia and other atrophic.
In other areas there is marked hyperplasia and dysplasia of follicular cells of authentic origin affecting intrafollicular areas and extending to interfollicular areas.
Areas frankly sarcomatous with fusiform cells that sometimes form syncytial.
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Immunohistochemistry: sarcomatous tumor cells with positive markers CD21 and CD35 for follicular cells of remnants.
In conclusion, follicular cell sarcoma arising from a hyalinovascular CD is a rare entity.
Bone marrow biopsy: hyperplasia of the three systems, without tumor recurrence.
The patient received treatment with local radiotherapy and remains asymptomatic to date.
