Hanlon Allison, Stasko Thomas, Christiansen Dan, Cyrus Nika, Galan Anjela
*Division of Dermatology, Department of Medicine, Vanderbilt University, Nashville, Tennessee; †Department of Dermatology, University of Oklahoma, Oklahoma City, Oklahoma; ‡Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.
Dermatol Surg. 2017 Mar;43(3):431-436. doi: 10.1097/DSS.0000000000001000.
Atypical fibroxanthoma (AFX) is a rare cutaneous spindled cell neoplasm. For both diagnostic and therapeutic purposes, it is important to distinguish AFX from other poorly differentiated tumors, including undifferentiated pleomorphic sarcoma (UPS).
The authors aimed to identify the clinical, histologic, and immunohistochemical expression of LN2, ezrin, and CD10 in AFX and UPS tumors.
The authors retrospectively examined the charts of patients with AFX and UPS treated with Mohs micrographic surgery (MMS) at 2 academic institutions. Patient demographics, tumor characteristics, and clinical course data were collected. Immunohistochemical stains were performed on primary and recurrent AFX and UPS tumors with monoclonal antibodies against the B-cell marker LN2 (CD74), CD10, and ezrin.
In the series of 169 patients with AFX included in this study, local recurrence was rare at 3%. In contrast, the seven patients with UPS had an aggressive clinical course with 1 local recurrence and 2 distant metastases. Immunohistochemistry staining for ezrin, LN2, and CD10 were similar in AFX and UPS tumors.
AFX can be treated with MMS with rare instances of recurrence. Undifferentiated pleomorphic sarcoma has a more aggressive clinical course with increased risk for recurrence and metastasis. Staining with ezrin, LN2, and CD10 did not differentiate AFX or UPS tumors.
非典型纤维黄色瘤（AFX）是一种罕见的皮肤梭形细胞肿瘤。出于诊断和治疗目的，将AFX与其他低分化肿瘤（包括未分化多形性肉瘤（UPS））区分开来很重要。
作者旨在确定AFX和UPS肿瘤中LN2、埃兹蛋白和CD10的临床、组织学和免疫组化表达。
作者回顾性研究了在2家学术机构接受莫氏显微外科手术（MMS）治疗的AFX和UPS患者的病历。收集患者人口统计学、肿瘤特征和临床病程数据。使用针对B细胞标志物LN2（CD74）、CD10和埃兹蛋白的单克隆抗体对原发性和复发性AFX和UPS肿瘤进行免疫组化染色。
在本研究纳入的169例AFX患者系列中，局部复发率很低，为3%。相比之下，7例UPS患者临床病程侵袭性强，有1例局部复发和2例远处转移。AFX和UPS肿瘤中埃兹蛋白、LN2和CD10的免疫组化染色相似。
AFX可用MMS治疗，复发情况罕见。未分化多形性肉瘤临床病程更具侵袭性，复发和转移风险增加。埃兹蛋白、LN2和CD10染色无法区分AFX或UPS肿瘤。
