Jakobiec Frederick A, Tu Yufei, Zakka Fouad R, Tong Arthur K F
Department of Ophthalmology; The David Cogan Ophthalmic Pathology Laboratory, Massachusetts Eye and Ear Infirmary; Harvard Medical School.
Department of Ophthalmology; The David Cogan Ophthalmic Pathology Laboratory, Massachusetts Eye and Ear Infirmary; Harvard Medical School.
Surv Ophthalmol. 2017 Jul-Aug;62(4):533-540. doi: 10.1016/j.survophthal.2016.12.007. Epub 2016 Dec 22.
Dermatofibromas are most frequently encountered in women on the lower extremities, often after minor trauma. A recurrent lesion of the right lower eyelid developed in a 64-year-old woman. It harbored "monster cells" that were large, with either multiple nuclei or a single, large, convoluted, and hyperchromatic nucleus. The presence of these cells does not signify a malignant transformation. The background cells were either histiocytoid (many were adipophilin positive), spindled cells, or dendritiform cells without mitoses. Factor XIIIa, CD68, and CD163 immunostaining was positive, and a subpopulation of CD1a Langerhans cells was intermixed. Facial and eyelid dermatofibromas are more likely to recur and deserve wider, tumor-free surgical margins. Their microscopic differential diagnosis includes a cellular scar, peripheral nerve tumor, atypical fibrous xanthoma, and dermatofibrosarcoma protuberans.
