Follicular dendritic cell sarcoma is a rare tumor that occurs mainly in lymph nodes. We report a case of follicular dendritic cell sarcoma in a cervical lymph node that was initially diagnosed as a B-cell lymphoma by Tru-Cut biopsy. The correct diagnosis was established by excision biopsy and immunohistochemistry. This tumor is of interest to head and neck surgeons because its recurrence rate is significant and its metastatic potential has been underestimated because of its rarity and the difficulty in making the diagnosis. We discuss the salient clinical and pathologic features of this tumor, as well as its management protocol, and we review the literature.