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PubMed2005

[Melanoma simulating malignant soft tissue tumour].

The authors presented the case of an 82-year-old man with primary nodular melanoma of the skin on the back (Breslow 3 mm) which repeatedly metastasized five times to the cervical lymph nodes. Metastases were excised. The aim of this report was to demonstrate changes in the phenotype and immunophenotype during tumour progression. Originally round and oval melanoblasts had a characteristic immunophenotype. They were S100 protein, HMB45, Malan A, MITF positive. From the second biopsy the immunophenotype began to change, and the amount of positive cells declined. In the succeeding biopsies the morphology was also changed. There were spindle cells which formed mutually intermingled bundles in places with large multinucleate cells. The histological pattern assembled malignant mesenchymal tumour - type malignant fibrous histiocytoma. The immunophenotype was also changed. The second to fifth metastases in the cervical region were only S100 protein positive. The other above-mentioned melanoma markers were negative. Differential diagnosis includes neurotropic-desmoplastic malignant melanoma, Bednár tumour (pigmented dermatofibrosarcoma protuberans; storiform neurofibroma), malignant peripheral nerve sheath tumour (neurogenic sarcoma) and malignant fibrous histiocytoma.

Aged, 80 and over↗
PubMed2005

The myofibroblast: a study of normal, reactive and neoplastic tissues, with an emphasis on ultrastructure. part 2 - tumours and tumour-like lesions.

This paper describes the ultrastructure of the commoner myofibroblastic tumours and tumour-like lesions. The objective is to complement mainstream pathology texts, which have concentrated on the clinical and light microscopy features of these lesions and which have arguably but understandably somewhat neglected electron microscopy as an ancillary diagnostic tool and a technique for investigating tumour cell biology. Ultrastructural features are described of nodular fasciitis, the myofibromatoses (including Dupuytren's disease), inflammatory myofibroblastic tumour, post-operative spindle cell nodule, fibroma of tendon sheath, fibrous pseudotumour, benign fibrous histiocytoma, atypical fibroxanthoma, dermatofibrosarcoma protuberans, myofibrosarcoma (myofibroblastic sarcoma), malignant fibrous histiocytoma (pleomorphic myofibrosarcoma), epithelioid sarcoma and spindle-cell carcinoma. Fibrosarcoma and leiomyosarcoma are illustrated for comparison. The fibronexus is emphasised as an important marker for the most confident diagnosis of myofibrosarcoma. Some pathologists accept a light microscope definition, which includes alpha-smooth-muscle actin positivity, h-caldesmon negativity and, in some cases, desmin positivity. Caution in the interpretation of desmin staining in a possible myofibroblastic lesion is urged, since, in combination with an ultrastructurally identified lamina, it more probably suggests true smooth-muscle differentiation. Myofibroblastoma and angiomyofibroblastoma are examples of tumours argued on the basis of ultrastructural findings (sometimes in combination with desmin staining) to be primitively differentiated smooth-muscle cell rather than myofibroblastic proliferations.

Adolescent↗
PubMed2006

[Mohs micrographic surgery: concept, technic and indications].

Mohs Micrographic Surgery is a technic to treat severe cutaneous carcinoma. By performing a microscopic and topographic analysis of the whole tissue excised, both a reduction of the surgical margin and margins in normal tissue is obtained. The major indications of micrographic surgery are recurrent basalcell carcinoma after surgery or radiotherapy, not fully excised or localized on the nose and the mediofacial region, some spinouscell carcinoma and dermatofibrosarcoma protuberans.

Humans↗
PubMed2006

Tumoral, quasitumoral and pseudotumoral lesions of the superficial and somatic soft tissue: new entities and new variants of old entities recorded during the last 25 years. Part XII: appendix.

In an eleven part series published in Pathologica, we have presented various tumoral, quasitumoral and pseudotumoral lesions of the superficial and somatic soft tissue (ST), which emerged as new entities or as variants of established entities during the last quarter of a century. Detailed clinicomorphological and differential diagnostic features of approximately sixty entities were chosen on the basis of their clinical significance and morphologic distinctiveness. The series included fibrous and myofibroblastic tumors (e.g. solitary fibrous tumor, high grade classic and pigmented dermatofibrosarcoma protuberans, inflammatory myofibroblastic tumor and myofibrosarcomas), fibromyxoid and fibrohistiocytic neoplasms (e.g., Evans' tumor, phosphaturic mesenchymal tumor, inflammatory myxohyaline tumor), special adipocytic/vascular/and smooth muscle lesions (e.g., chondroid lipoma, Dabska's tumor, ST hemangioblastoma, lipoleiomyosarcoma), epithelioid mesenchymal malignancies of diverse lineages (e.g., epithelioid liposarcoma, proximal-type epithelioid sarcoma, neuroendocrine extraskeletal chondromyxoid sarcoma), ST Ewing's tumor and peripheral nerve sheath tumors (perineuriomas and pigmented and rosetting tumors of the schwannoma/neurofibroma group), extranodal dendritic or histiocytic proliferative processes (follicular dendritic cell sarcoma, Rosai-Dorfman disease, Castleman's disease, and plexiform xanthomatous tumor), and tumors with myoepithelial differentiation. The section devoted to selected pseudotumoral entities considered representatives of the hamartoma group (neural fibrolipomatous hamartoma, ectopic hamartomatous thymoma, rudimentary meningocele), metabolic diseases (amyloid tumor, nephrogenic fibrosing dermopathy, tophaceous pseudogout, pseudoinfiltrative parathyromatosis), stromal tissue reactions to trauma (fibroosseous pseudotumors of digits) and infections (bacillary angiomatosis), and normal organs (glomus coccygeum). To conclude the descriptive phase, supplementary material has now been collected and appended in an attempt to provide a quick digest of essential knowledge both for comparison and differential diagnosis. The data have been tailored to synthesize diverse sources, integrating clinical elements and references to articles that previously appeared in Part I ("Introduction"), Part II ("The List and Review of New Entities") and Parts III to XI ("Excerpta"). At the very least we hope this final part ("Appendix") will provide the reader with a useful tabular organization of ST lesions and a reference resource.

Humans↗
PubMed1991

Storiform neurofibroma (Bednar tumor). A case report.

Clinical data and morphological features of the storiform neurofibroma, presenting as an exophytic tumor of the trunk in 30 years old white man are described. This benign tumor, is microscopically similar to dermatofibrosarcoma protuberans and differs from the letter by the presence of melanin containing cells.

Adult↗
PubMed1990

Benign fibrous histiocytoma of subcutaneous and deep soft tissue: a clinicopathologic analysis of 21 cases.

Twenty-one cases of benign fibrous histiocytoma arising in noncutaneous soft tissue are reported. These tumors presented most often in young to middle-aged adults with a predominance in males. They originated in deep subcutis (16 cases), skeletal muscle (three cases), and mesentery (two cases). The most common sites of incidence were the lower limb (eight cases) and head and neck region (six cases). Four of 12 cases with follow-up (median 3.0 years) recurred locally; all had originated in the subcutis. None metastasized. These lesions are generally larger and better circumscribed than their cutaneous counterparts. They are also usually more monomorphic and have a more consistent storiform pattern than the latter. A pericytomalike vascular pattern (six cases), xanthoma cells (six cases), and multinucleate giant cells (six cases) may be prominent. Hyaline or myxoid degeneration of the stroma is common. Rare features include small foci of necrosis and intravascular growth. Immunohistochemically, deep benign fibrous histiocytoma shows no evidence of true monocyte/macrophage differentiation and its histogenesis remains uncertain. The differential diagnosis includes malignant fibrous histiocytoma, dermatofibrosarcoma and hemangiopericytoma.

Adolescent↗
PubMed1990

[The storiform M-8333/1,3 neurofibroma].

Attention concentrated on features of storiform neurofibroma failed to find an unambiguous universal interpretation. 15 consecutively published cases were collectively revised with partial conclusions from a comparison of findings and references: Nosological identity of dermatofibrosarcoma protuberans and its "pigmented variant" is substantiated but fails to solve histogenetic embarrassment of both items. Characteristic storiform structure is connected with layered very flat cells. No doubt they remind of spindle-shaped fibroblasts in cross section but flat dendritic cells remain an essential component no matter whether pigmented or not. Open to discuss is whether fibroblasts belong to adaptable cells which generally can get a flat shape among dendritic cells. Their pigmentation may have local origin according to paraneuronal theory.

Fibrosarcoma↗
PubMed1989

[Lysozyme-positive cells and ultrastructural findings in granulomatous and histiocyte-proliferative skin diseases].

Immunohistochemically, the presence of lysozyme (LZ) has been detected by the antibody against human LZ in cytoplasm of cells from granulomatous and histiocyte-proliferative skin diseases. To detect LZ in these cells morphologically, I have done electron microscopic observations of the following skin diseases; sarcoidosis, lupus vulgaris, lupus miliaris disseminatus faciei (LMDF), tattoo granuloma, lichen nitidus, foreign body granuloma, granuloma annulare, xanthelasma, xanthoma tuberosum, xanthoma planum, juvenile xanthogranuloma, giant cell tumor of tendon sheath, dermatofibroma, malignant fibrous histiocytoma, dermatofibrosarcoma protuberans, granulation tissue of burn, hypertrophic scar, and histiocytosis X. From both the immunohistochemical and the electron microscopic features it was concluded that a) immunohistochemically LZ-positive cells from lesions of sarcoidosis, lupus vulgaris, LMDF and tattoo granuloma had a number of electron-lucent bodies (ELB) or microvesicles in their cytoplasm, b) lichen nitidus and xanthoma tuberosum had few LZ-positive cells and the ELB were not observed, and c) the other diseases were LZ-negative, and the ELB were also absent. It is suggested that LZ is present in the ELB which are observed electron microscopically.

Granuloma↗
PubMed1989

[Incidence of malignant, primary and metastatic solid skin tumors at a pediatric dermatology service].

The incidence of primary and metastatic cutaneous malignant solid tumors was investigated in a pediatric dermatology department. Among 25,000 first time patients seen between 1971 and 1985, 19 had cutaneous malignant solid tumors with an annual incidence of 0.7 for every 1,000 pediatric dermatology patients. Nine cases had primary cutaneous tumors and 10 cases metastatic tumors. The majority of patients were infants (zero to two years). The tumors found were rhabdomyosarcoma, six cases; basal-cell carcinoma, four cases; neuroblastoma, three cases; malignant melanoma, two cases, squamous-cell carcinoma, dermatofibrosarcoma, atypical fibroxanthoma and myxopapillary ependymoma, one case of each. Predisposing factors for the developing of malignancy were present in 42% of patients.

Adolescent↗
PubMed1989

[Benign cutaneous fibrohistiocytoma. Morphological analysis of 176 cases].

We report a review of the morphologic and topographic characteristics of 176 cases of cutaneous fibrous histiocytoma. We confirm its prevalence in females with greater incidence of location in the limbs. Among the morphologic varieties the most frequent is the fibro-collagenous. The most common differential diagnosis comprises dermatofibrosarcoma protuberans, atypical fibroxanthoma, malignant fibrous histiocytomas and idiopathic fibromatosis. Its histogenesis from mesenchymal immature elements and its tendency toward fibrohistiocytic differentiation is generally accepted.

Adult↗
PubMed1986

[Malignant fibrous histiocytomas].

Malignant fibrous histiocytomas of the storiform pleomorphic type were found in the lower legs of two patients, 79 and 42 years of age. In the first, dermatofibrosarcoma protuberans, in the second, squamous cell carcinoma, had to be discussed. In the first patient, the tumor arose in the area of a preexisting paresis of the superficial peroneal nerve; the second patient developed the tumor in fistulous osteomyelitis existing since childhood.

Adult↗
PubMed1988

Skin cancer in blacks in the United States.

Skin cancer is rare in blacks compared with whites in the United States. The most common form is squamous-cell carcinoma, not basal-cell carcinoma, as it is in whites. Sunlight does not appear to be an important etiologic factor in skin cancer in blacks, as most lesions occur on covered areas. Malignant melanoma is low in frequency but commonly affects acral areas and has a poor prognosis. Mycosis fungoides and dermatofibrosarcoma protuberans appear to have a high frequency among skin cancers. Squamous-cell carcinoma, malignant melanoma, and mycosis fungoides have a relatively high mortality rate in blacks. Bowen's disease and Kaposi's sarcoma occur in blacks but are rare. As there is a high frequency of squamous-cell carcinoma of the skin in blacks, prevention and early detection should benefit the patient. Considering the difficulties encountered in applying epidemiologic methods to skin cancer on a national scale, etiologic studies should be conducted in carefully selected areas. Future investigations of skin cancer in blacks should include an examination of risk factors such as burns, trauma, and diet and familial and immunologic aspects as well.

Black People↗
PubMed1988

[Fibrosarcoma: immunohistochemical study of the extracellular matrix].

Immunofluorescent examination of extracellular matrix of 5 fibrosarcomas showed the matrix to contain fibronectin and collagen type I, III, V. Fibrosarcoma matrix is characterized by the absence of collagen type IV and collagen type III predominance over type I differentiating this tumor from synovial sarcoma, neurogenic sarcoma, dermatofibrosarcoma protuberans, malignant fibrous histiocytoma. Their matrices showed the presence of type IV collagen, equal proportion of interstitial collagens or collagen type I predominance over type III typical for synovial sarcoma. The findings can be employed in practical morphologic diagnosis of soft tissue tumors.

Collagen↗
PubMed1988

Histological changes in recurrent soft tissue sarcomas: analysis of 56 patients.

Histological changes in 56 patients with recurrent soft tissue sarcomas (STS) were analysed. The original tumors included 23 malignant fibrous histiocytomas, five liposarcomas, four leiomyosarcomas, four synovial sarcomas, four neurogenic sarcomas, four dermatofibrosarcomas and 12 other assorted tumor types. The histological features of the recurrent tumors which underwent changes included increased cellularity, an increased number of mitotic figures, extension of sclerotic areas and the appearance of a storiform pattern; these were found in 30%, 43%, 41% and 29% of cases, respectively. No case showed a histological change from one subtype to another. A follow-up study revealed increased cellularity and mitotic counts in the recurrent tumors to be signs of an unfavorable prognosis.

Adolescent↗
PubMed1986

Primary scalp cancer in Singapore.

Cancers of the scalp are uncommon. Owing to their unique site they pose problems in surgical treatment. A retrospective study of all scalp cancers notified to the Singapore Cancer Registry over 17 years has shown that squamous cell carcinoma is the most common cancer followed by basal cell carcinoma. Other cancers are sweat gland carcinoma, angiosarcoma, dermatofibrosarcoma protruberans, liposarcoma, fibrosarcoma and malignant lymphoma. Scalp cancers are more common in Chinese and very rare in Indians. There is no difference in the incidence between the sexes. The surgical treatment and reconstructive techniques employed in 52 patients are described. When localised, scalp cancers are managed like other skin cancers but once they invade bone, they become aggressive and are difficult to eradicate. Wide radical excision provides cure and the skull bone if involved should be removed.

Adolescent↗
PubMed1987

Skin cancer in black Americans: a review of 126 cases.

Primary cancer of the skin is rare in blacks. The records of 126 black patients with skin cancer were reviewed. Histopathologic findings included squamous cell carcinomas (43) basal cell carcinomas (39) malignant melanomas (8) dermatofibrosarcomas (16) Bowen's disease (6) mycosis fungoides (14) and sebaceous cell carcinoma (1).There is a higher percentage of skin cancer involving covered areas in blacks than among whites. Squamous cell carcinoma was the most common skin cancer in blacks. The distribution of basal cell carcinoma in blacks was 30 percent in this series, as compared with 80 percent in whites in the 1977 to 1978 survey. The majority of patients with squamous cell carcinoma had associated predisposing conditions and lesions on non-sun-exposed skin. Sunlight and occupational chemical exposure did not appear to be associated with skin cancer in blacks in this series.

Adult↗
PubMed1983

Prekeratin in spindle cell tumors of the skin.

A variety of benign and malignant skin lesions was stained for the presence of prekeratin using an unlabeled antibody peroxidase-antiperoxidase method and an antibody raised against human prekeratin protein. No prekeratin could be detected in benign or malignant lesions derived from melanocytes, and prekeratin could not be found in atypical fibroxanthoma, Kaposi's sarcoma, angiosarcoma, dermatofibrosarcoma protruberans, and leiomyosarcoma. Paget's cells did not contain prekeratin. Varying staining intensities were observed in keratinocytic atypical hyperplasias. Of particular interest is the observation that many spindle cell lesions that were difficult to identify with 100% assurance from routine stains could be positively identified as squamous cell carcinoma after prekeratin was found in the atypical cells.

Animals↗
PubMed1994

Endothelial cell markers CD31, CD34, and BNH9 antibody to H- and Y-antigens--evaluation of their specificity and sensitivity in the diagnosis of vascular tumors and comparison with von Willebrand factor.

Sixty vascular tumors including 23 angiosarcomas, 300 nonvascular tumors, and selected normal tissues were immunohistochemically evaluated with antibodies to CD31, CD34, and von Willebrand factor (vWF), and monoclonal antibody BNH9, to test the sensitivity and specificity of these markers in the identification of endothelial cells and vascular tumors. Formaldehyde-fixed paraffin-embedded tissues and avidin biotin complex immunostaining were used. All markers labeled normal vascular and lymphatic endothelial cells approximately equally with the exception of CD34 which showed inconsistent expression within the lymphatics. In addition, antibody to CD31 reacted with platelets and megakaryocytes, CD34 with fibroblasts and aortic smooth muscle cells, and BNH9 with many epithelial cells including squamous and gastrointestinal epithelia. Antibody to vWF often showed significant stromal background staining which made the staining occasionally uninterpretable. Benign vascular tumors showed rather uniform staining with all antibodies. However, angiosarcomas were heterogeneous; CD31 was positive in 21/27, CD34 in 25/27 cases, BNH9 in 22/25, and vWF in 18/27 cases. Epithelioid hemangioendotheliomas showed consistent labeling for vWF, but were inconsistently labeled with antibodies to the other markers. Kaposi's sarcoma was positive for both CD31 and CD34. In addition, antibody to CD34 labeled the tumor cells in hemangiopericytoma, cerebellar hemangioblastoma, meningioma, most epithelioid sarcomas, dermatofibrosarcomas, and in a few other sarcomas. CD31, in turn, was not found in sarcomas other than angiosarcomas, but labeled weakly occasional carcinomas and mesotheliomas. Many adenocarcinomas and the glandular component of synovial sarcoma were BNH9 positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Monoclonal↗