Kram Andrzej, Stańczyk Jerzy, Woyke Stanisław
Department of Pathomorphology, Pomeranian Medical University, Szczecin.
Pol J Pathol. 2003;54(4):267-71.
We report two rare examples of dermal fibrohistiocytic stromal tumors: one case of atypical fibrous histiocytoma (AFH) and another one of atypical fibroxanthoma (AFX), which can be confused in surgical pathology diagnosis with high-grade malignant neoplasm. Histologically, a proliferation of mononuclear, spindle-shaped, or histiocytoid cells and/or multinucleated cells, usually admixed with inflammatory cells was observed in both cases, but some clinicopathological differences allowed their distinction. Immunohistochemistry is of a little help in differential diagnosis between these two entities however, it is very useful in differentiating with other groups of tumors. Recognition of AFH and AFX is important, especially to prevent incorrect aggressive treatment in those cases that may be confused with high-grade sarcoma. Because of the potentially aggressive behavior in rare cases and the lack of clear-cut predictive morphologic patterns that would specify a poor clinical outcome, complete surgical excision in all cases is recommended.
一例非典型纤维组织细胞瘤（AFH）和另一例非典型纤维黄色瘤（AFX），这两种肿瘤在外科病理诊断中可能会与高级别恶性肿瘤混淆。组织学上，两例均观察到单核、梭形或组织细胞样细胞和/或多核细胞的增殖，通常伴有炎症细胞，但一些临床病理差异有助于区分它们。免疫组织化学在这两种实体的鉴别诊断中帮助不大，然而，它在与其他肿瘤组的鉴别中非常有用。认识AFH和AFX很重要，特别是为了防止在那些可能与高级别肉瘤混淆的病例中进行错误的积极治疗。由于在罕见情况下可能具有侵袭性行为，且缺乏明确的预测形态学模式来确定不良临床结果，因此建议在所有病例中进行完整的手术切除。
