Cytopathos s.r.o., Bratislava, Slovak Republic.
Ann Diagn Pathol. 2010 Feb;14(1):36-40. doi: 10.1016/j.anndiagpath.2009.09.004. Epub 2009 Dec 11.
Juvenile xanthogranuloma is a relatively rare cutaneous tumor of histiocytic origin, occurring mainly in neonates, children, and young people in the first 2 decades of life. An occurrence in adults is rare. Very rare is also a "deep" subcutaneous and intramuscular localization of this tumor that is called in such case as "deep juvenile xanthogranuloma." A very uncommon variant of this tumor is the so-called mitotically active xanthogranuloma, which was described in the literature only in a single case. We present an interesting case of the mitotically active intramuscular juvenile xanthogranuloma of the upper arm in a 28-year-old woman. Before surgical excision, the tumor was examined by fine-needle aspiration biopsy. A diagnosis of deep malignant melanoma or alveolar rhabdomyosarcoma was considered. One year after the total excision, the patient is free of disease. In the presented case, we emphasize cytologic-histologic correlation. In the differential diagnosis, we considered especially an atypical diffuse giant cell tumor of tendon sheaths and joints (extra-articular pigmented villonodular synovitis) and some rare types of soft tissue leiomyosarcoma, such as epitheloid leiomyosarcoma and leiomyosarcoma with prominent osteoclast-like giant cells.
幼年黄色肉芽肿是一种相对罕见的组织细胞来源的皮肤肿瘤，主要发生于新生儿、儿童和 20 岁以下的年轻人。成年人发病罕见。这种肿瘤非常罕见的还有一种“深部”皮下和肌肉内定位，在这种情况下称为“深部幼年黄色肉芽肿”。这种肿瘤非常罕见的变异型是所谓的有丝分裂活跃性黄色肉芽肿，文献中仅描述过一例。我们报告了一例有趣的 28 岁女性上臂有丝分裂活跃性肌内幼年黄色肉芽肿。在手术切除前，对肿瘤进行了细针抽吸活检。最初考虑诊断为深部恶性黑色素瘤或肺泡横纹肌肉瘤。完全切除后 1 年，患者无病生存。在本病例中，我们强调了细胞学-组织学相关性。在鉴别诊断中，我们特别考虑了一种不典型弥漫性腱鞘和关节巨细胞肿瘤（关节外色素绒毛结节性滑膜炎）和一些罕见类型的软组织平滑肌肉瘤，如上皮样平滑肌肉瘤和伴有显著破骨样巨细胞的平滑肌肉瘤。
