Hepatic Epstein–Barr Virus–Positive Inflammatory Follicular Dendritic Cell Sarcoma: A Diagnostic Imaging Challenge - A Focused Review and Case Report

Background: Epstein–Barr Virus-Positive Inflammatory Follicular Dendritic Cell Sarcoma (EBV+ IFDCS) is a rare low-grade malignant neoplasm. Preoperative diagnosis of EBV+ IFDCS is challenging because it lacks specific clinical or laboratory manifestations as well as distinctive imaging features. This report presents a case of hepatic EBV+ IFDCS and reviews the relevant literature. The study summarized the imaging characteristics of this condition and provided insights to support preoperative imaging evaluation. Case Presentation: A 54-year-old asymptomatic woman was found to have a hepatic mass during a routine health screening and subsequently underwent surgical resection. Preoperative computed tomography and magnetic resonance imaging identified a lesion in the left hepatic lobe. The mass demonstrated marked but heterogeneous enhancement in the arterial phase, followed by decreased enhancement in the portal venous and delayed phases. The diagnosis of hepatic EBV+ IFDCS was confirmed by histopathological examination. Conclusion: Because the imaging findings of hepatic EBV+ IFDCS are variable, preoperative diagnosis remains challenging. This report aims to improve recognition of the imaging characteristics of this disease.