Stojsic Zorica, Brasanac Dimitrije, Stojanovic Martina, Boricic Mladen
Dr. Dimitrije Brasanac, Institute of Pathology,, Faculty of Medicine,, University of Belgrade,, Belgrade 11000, Serbia, T: +381.11-3643410;, F: +381-11-3643346,
Ann Saudi Med. 2014 Mar-Apr;34(2):182-8. doi: 10.5144/0256-4947.2014.182.
Composite hemangioendothelioma (CHE) is a rare, locally aggressive, vascular tumor of intermediate-/ low-grade malignancy, and is characterized by varying combinations of benign, low-grade malignant, and malignant vascular components. In cutaneous localization, only 22 cases have been reported so far. A new case of CHE of the gluteal region in a 58-year-old man is described. Microscopically, vascular neoplasm, situated mainly within the deep dermis and the subcutaneous fat tissue, was composed of sinusoidal hemangioma, arteriovenous hemangioma, retiform hemangioendothelioma (RHE), and angiosarcoma. An average number of mitoses within the angiosarcomatous component was 10 per 10 high-power fields. Immunohistochemically, the tumor cells were positive for factor VIII-related antigen, CD34, and CD31 and negative for D2-40 and GLUT-1. Ki-67 labeling index was 21%, 1.2%, and 0% in the areas of angiosarcoma, RHE, and sinusoidal hemangioma, respectively. No recurrent disease was noted 3 months after the surgery. The present case displayed the following features previously undescribed in CHE: a novel component of sinusoidal hemangioma and localization at the gluteal region. We also provide review of clinical, histopathological, and immunohistochemical characteristics of cutaneous CHE from the published cases.
复合性血管内皮瘤（CHE）是一种罕见的、局部侵袭性的、中/低级别恶性的血管肿瘤，其特征是良性、低级别恶性和恶性血管成分的不同组合。在皮肤定位方面，迄今为止仅报道了22例。本文描述了一名58岁男性臀区CHE的新病例。显微镜下，血管肿瘤主要位于真皮深层和皮下脂肪组织内，由窦性血管瘤、动静脉血管瘤、网状血管内皮瘤（RHE）和血管肉瘤组成。血管肉瘤成分内每10个高倍视野的平均有丝分裂数为10个。免疫组化显示，肿瘤细胞因子VIII相关抗原、CD34和CD31呈阳性，D2-40和GLUT-1呈阴性。在血管肉瘤、RHE和窦性血管瘤区域，Ki-67标记指数分别为21%、1.2%和0%。术后3个月未发现复发病例。本病例表现出CHE以前未描述的以下特征：窦性血管瘤的新成分和臀区定位。我们还对已发表病例中皮肤CHE的临床、组织病理学和免疫组化特征进行了综述。
