Suárez-Vilela Dimas, Izquierdo-García Francisco, Domínguez-Iglesias Francisco, Méndez-Álvarez Jose Ramón
Department of Anatomía Patológica, Hospital Valle del Nalón, Riaño, Spain.
Case Rep Dermatol. 2010 May 7;2(2):69-75. doi: 10.1159/000314232.
We describe a case of papillated Bowen disease (PBD), associated with a clear cell atypical fibroxanthoma (CCAFXA). The epidermal lesion showed a bowenoid papillomatous growth pattern with histologic features suggestive of infection by human papilloma virus (HPV). In the dermis a neoplasm made up by spindled or polygonal cells with wide clear cytoplasm and moderate nuclear pleomorphism was found. Immunohistochemical characteristics of these two lesions were clearly different. The atypical cells of the intraepidermal proliferation were positive for AE1-AE3 anticytokeratin antibody, EMA, p16, p53 and p63. The dermal tumor was positive for vimentin, CD10, CD68, CD99, alpha-1-antitrypsin and c-kit. Histological features and immunohistochemical profile of the dermal tumor corresponded to a CCAFXA, a very uncommon neoplasm of which only 10 cases have been reported. In situ hybridization for numerous types of HPVs was negative in both lesions.
我们描述了一例伴有透明细胞非典型纤维黄色瘤（CCAFXA）的乳头状鲍恩病（PBD）。表皮病变呈现鲍恩样乳头瘤样生长模式，组织学特征提示人乳头瘤病毒（HPV）感染。在真皮层发现了一种由梭形或多角形细胞组成的肿瘤，这些细胞具有宽阔的透明细胞质和中度核异型性。这两种病变的免疫组织化学特征明显不同。表皮内增殖的非典型细胞对AE1-AE3抗细胞角蛋白抗体、EMA、p16、p53和p63呈阳性。真皮肿瘤对波形蛋白、CD10、CD68、CD99、α1-抗胰蛋白酶和c-kit呈阳性。真皮肿瘤的组织学特征和免疫组织化学特征符合CCAFXA，这是一种非常罕见的肿瘤类型，仅报道过10例。两种病变的多种HPV原位杂交均为阴性。
