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Report of an angiosarcoma
mimic: cutaneous aneurysmal fibrous histiocytoma.
APMIS. 2006 Oct;114(10):744-8.
Aneurysmal fibrous
histiocytoma is an unusual variant of the spectrum of fibrous histiocytomas
with the peculiar morphologic appearance of a benign aneurysmal
vasoformative process that ultimately culminates in multiple
microhemorrhages within the tumor. It looks strikingly different from the
usual cutaneous lesions encountered in clinical dermatology practice. A
single report of a cutaneous aneurysmal fibrous histiocytoma in the skin of
the back of a 60-year-old male is described with emphasis on the
immunostaining pattern and review of the literature. There is a significant
potential for confusion of this lesion with other cutaneous lesions,
clinically as well as pathologically. In our case, the patient presented
with a lesion that clinically resembled a hemangioma, was pathologically
interpreted initially to be an angiosarcoma, and finally, the revised
pathology was interpreted as an aneurysmal variant of a fibrous histiocytoma.
Caution is warranted to avoid misinterpretation of cutaneous
fibrohistiocytic tumors.
Aneurysmal fibrous
histiocytoma showing transition from factor XIIIa-positive to -negative.
J Dermatol. 2002 Nov;29(11):744-7.
A 39-year-old woman
visited us because of a subcutaneous induration on her forehead of 7 months'
duration. The tumor was tender, firm, and colored blue-black.
Microscopically, the tumor was composed of fibroblastic and histiocytic
cells showing no atypicality. In some part intra- or extracellular
haemosiderin was diffusely seen. There were some blood-filled spaces of
varying size without endothelial lining. From these findings, this case was
diagnosed as aneurysmal fibrous histiocytoma (AFH), a variant form of
dermatofibroma. Immunohistochemical analysis showed that factor XIIIa-positive
histiocytic cells were distributed in the area without haemosiderin, but
such cells were absent in the area with its deposition. Furthermore, the
cells near the blood-filled space showed transition from factor XIIIa-positive
to -negative, suggesting that the stromal instability induced by the
attenuation of factor XIII may lead the formation of the blood-filled spaces
in AFH. |
