Wang Jian, Yang Wentao
Department of Pathology, Cancer Hospital, Shanghai Medical School of Fudan University, Shanghai, China.
J Cutan Pathol. 2008 Oct;35 Suppl 1:65-9. doi: 10.1111/j.1600-0560.2007.00963.x. Epub 2008 Jun 9.
Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive skin tumor. In addition to the conventional type, several morphologic variants have been described. Recognition of these uncommon variants will facilitate the diagnosis. We report herein a peculiar case of pigmented DFSP (Bednar tumor) with prominent meningothelial-like whorls, a distinctive pattern that has not been described previously in DFSP. The tumor occurred in a 40-year-old man who presented with a slowly growing mass on his left shoulder. The overall histological features were consistent with Bednar tumor. However, unexpected numerous meningothelial-like whorls were found in some areas of the tumor. Like the tumor cells in typical areas of Bednar tumor these meningothelial-like whorls were also positive for CD34 but negative for epithelial membrane antigen and S100 protein. The meningothelial-like whorls in Bednar tumor represent an eccentric arrangement of the tumor cells. We propose the term 'pigmented DFSP with prominent meningothelial-like whorls' to highlight the distinctive pattern of this novel DFSP variant.
隆突性皮肤纤维肉瘤(DFSP)是一种具有局部侵袭性的皮肤肿瘤。除了传统类型外,还描述了几种形态学变异型。认识这些不常见的变异型将有助于诊断。我们在此报告一例特殊的色素性DFSP(贝德纳瘤),其具有显著的脑膜上皮样漩涡,这是一种在DFSP中以前未被描述过的独特模式。该肿瘤发生在一名40岁男性身上,他的左肩部出现了一个缓慢生长的肿块。总体组织学特征与贝德纳瘤一致。然而,在肿瘤的一些区域发现了意想不到的大量脑膜上皮样漩涡。与贝德纳瘤典型区域的肿瘤细胞一样,这些脑膜上皮样漩涡CD34也呈阳性,但上皮膜抗原和S100蛋白呈阴性。贝德纳瘤中的脑膜上皮样漩涡代表肿瘤细胞的偏心排列。我们提出“具有显著脑膜上皮样漩涡的色素性DFSP”这一术语,以突出这种新型DFSP变异型的独特模式。