Rudisaile Sarah N, Hurt Mark A, Santa Cruz Daniel J
Cutaneous Pathology, WPC Laboratories, Inc., Maryland Heights, MO 63043, USA.
J Cutan Pathol. 2005 Apr;32(4):314-7. doi: 10.1111/j.0303-6987.2005.00326.x.
We report on two patients with granular cell atypical fibroxanthoma. Both neoplasms were solitary, light-tan, dome-shaped papules on sun-exposed areas of the head in two elderly white men. Microscopically, these neoplasms showed a dermal proliferation of pleomorphic granular cells with irregular hyperchromatic nuclei, multinucleated cells, and scattered mitoses. Immunohistochemical stains were positive for CD68 and vimentin and negative for Melan-A or human melanoma black (HMB)-45, S-100 protein, pancytokeratin, and actin, consistent with atypical fibroxanthoma. The differential diagnosis of granular cells in neoplasms containing cytological pleomorphism is challenging in view of the many different neoplasms that may present with granular cytoplasm. These include the conventional granular cell tumor and its malignant form, leiomyoma, leiomyosarcoma, dermatofibroma, dermatofibrosarcoma protuberans, and angiosarcoma.
我们报告了两名患有颗粒细胞非典型纤维黄色瘤的患者。这两种肿瘤均为孤立性，呈浅褐色，圆顶状丘疹，位于两名老年白人男性头部的暴露于阳光下的部位。显微镜下，这些肿瘤显示真皮内多形性颗粒细胞增生，核不规则深染，有多核细胞，并有散在的有丝分裂象。免疫组化染色显示CD68和波形蛋白阳性，Melan-A或人黑色素瘤黑色（HMB）-45、S-100蛋白、全细胞角蛋白和肌动蛋白阴性，符合非典型纤维黄色瘤。鉴于许多不同的肿瘤可能出现颗粒状细胞质，对含有细胞多形性的肿瘤中的颗粒细胞进行鉴别诊断具有挑战性。这些肿瘤包括传统的颗粒细胞瘤及其恶性形式、平滑肌瘤、平滑肌肉瘤、皮肤纤维瘤、隆突性皮肤纤维肉瘤和血管肉瘤。
