Epstein-Barr virus+ inflammatory follicular dendritic cell sarcoma with clonal immunoglobulin heavy chain gene rearrangement: A case report and literature review.

Epstein-Barr virus+ inflammatory follicular dendritic cell sarcoma (EBV+ IFDCS) is a tumor with relatively inert biological behavior and low malignancy. Due to the lack of clinical features and non-specific imaging examinations, EBV+ IFDCS is difficult to diagnose preoperatively. The histological morphology and immunophenotype of EBV+ IFDCS are very broad, in which the presentation of EBV+ IFDCS with marked granulomatous changes is rare and can be confused with other granulomatous diseases. The present study reported a case of EBV+ IFDCS with marked granuloma formation. Notably, the present case report detected gene rearrangements using PCR-capillary electrophoresis and identified an amplification peak in the DH7-JH region of the immunoglobulin heavy chain, which has rarely been reported in previous cases, to the best of our knowledge. We hypothesized that this rearrangement may be associated with background B cells.