Follicular dendritic cell (FDC) sarcoma, especially of extranodal origin, is an extremely rare malignancy of FDC origin, with only 1 case previously documented in the thyroid. The authors report the case of a 58-year-old female who presented with a painless mass in her neck. The neoplastic cells expressed monocyte/macrophage-specific marker CD68 (KP-1) and lysozymes and the dendritic cell-associated antigens CD35 and Fascin but was negative for CD1a, CD21, and CD23, most consistent with a diagnosis of FDC sarcoma. BIOMED-2 multiplex polymerase chain reaction analysis showed B-cell clonality in both tumor and its adjacent coexisting Hashimoto’s thyroiditis. To the authors’ knowledge, this is the first report of a rare entity of FDC sarcoma primarily involving the thyroid gland coexisting with Hashimoto’s thyroiditis.
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