case_images: PMC10485249_01
case_images: Immunohistochemical staining (IHC) of spleen follicular dendritic cell sarcoma (FDCS). Hematoxylin and eosin staining 10X (A), 40X (B) . (C) Tumor cells were positive for CD35. (D) PD-L1 TPS 1%, CPS 10.
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case_images: PMC10485249_01_fimmu-14-1228653-g001.jpg
case_images: f1
case_images: Postoperative pathology showed that the tumor was positive for CD35, CD21, CD23 and CD20 ( Figures 1A-C ). To help establish the treatment for her, immunohistochemical (IHC) staining of PD-L1 ( Figure 1D ) and multiple immunofluorescences to evaluate the tumor microenvironment (TME) of this patient in both spleen FDCS cells and tumor stromal cells ( Figure 3 ) were carried out.
case_images: Computed tomography (CT) scan of the patient on treatment. (A1-A3) Pretreatment. (B1-B3) After 5 cycles of PD-1 inhibitor plus chemotherapy, CT showed partial response (PR). (C1-C3) After 8 cycles of PD-1 inhibitor plus chemotherapy combined with radiotherapy, CT showed sustained PR. The red arrows indicate lesion 1, yellow arrows indicate lesion 2, and blue arrows indicate lesion 3.
case_images: fimmu-14-1228653-g002.jpg
case_images: PMC10485249_01_fimmu-14-1228653-g002.jpg
case_images: f2
case_images: On the follow-up after one year, CT in October 2021 ( Figures 2A1-A3 ) indicated extensive intraperitoneal metastases, including in the original splenic zone and beside the left-side colon (the largest nodule size was 3.2*2.6 cm). AI (epirubicin plus ifosfamide) chemotherapy regimen plus sintilimab (anti-PD-1) every 3 weeks thereafter. After 5 cycles of combined treatment, a CT scan on March 5, 2022 ( Figures 2B1-B3 ) showed a decrease in the size of the nodules (the largest nodule size was 2.5*2.4 cm). Persistent PR was observed after 8 cycles of immunotherapy combined with chemotherapy plus radiotherapy ( Figures 2C1-C3 ).
case_images: Multiplex immunofluorescence of spleen follicular dentritic cell sarcoma (FDCS). (A) Immunofluorescence staining of PD-1 (green), PD-L1 (yellow), CD8 (magenta), CD68 (cyan), and CD163 (red). (B) Immunofluorescence staining of CD3 (magenta), CD4 (red), CD20 (green), CD56 (cyan), and FoxP3 (yellow).
case_images: fimmu-14-1228653-g003.jpg
case_images: PMC10485249_01_fimmu-14-1228653-g003.jpg
case_images: f3
case_images: On the follow-up after one year, CT in October 2021 ( Figures 2A1-A3 ) indicated extensive intraperitoneal metastases, including in the original splenic zone and beside the left-side colon (the largest nodule size was 3.2*2.6 cm). To help establish the treatment for her, immunohistochemical (IHC) staining of PD-L1 ( Figure 1D ) and multiple immunofluorescences to evaluate the tumor microenvironment (TME) of this patient in both spleen FDCS cells and tumor stromal cells ( Figure 3 ) were carried out. AI (epirubicin plus ifosfamide) chemotherapy regimen plus sintilimab (anti-PD-1) every 3 weeks thereafter. After 5 cycles of combined treatment, a CT scan on March 5, 2022 ( Figures 2B1-B3 ) showed a decrease in the size of the nodules (the largest nodule size was 2.5*2.4 cm). Persistent PR was observed after 8 cycles of immunotherapy combined with chemotherapy plus radiotherapy ( Figures 2C1-C3 ).