Deguchi Masatoshi, Aiba Setsuya
Department of Dermatology, JR Sendai Hospital, Sendai, Japan.
Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Case Rep Dermatol. 2017 Aug 17;9(2):136-140. doi: 10.1159/000478923. eCollection 2017 May-Aug.
Among the many variants of dermatofibroma, dermatofibroma with cholesterol cleft (cholesterotic fibrous histiocytoma) is extremely rare. Here, we describe the case of a 50-year-old male patient with a cholesterotic fibrous histiocytoma on his left lower leg. He presented with a hyperkeratotic nodule 6 mm in diameter with a brown surface on the extensor surface of his left lower leg. The lesion had developed over the course of a few years without any tendency to heal. A skin biopsy performed on the tumor showed histopathological findings compatible with those of dermatofibroma. Interestingly, the lesion included many cholesterol clefts, as well as foamy histiocytes and multinucleated giant cells around them. He had had metabolic syndrome for years. To the best of our knowledge, this is the first report of a cholesterotic fibrous histiocytoma in a patient with metabolic syndrome. We conclude that the altered microenvironment caused by metabolic syndrome, as well as hyperlipoproteinemia itself, may play a role in the pathogenesis of this rare case.
在皮肤纤维瘤的众多变体中，伴有胆固醇裂隙的皮肤纤维瘤（胆固醇性纤维组织细胞瘤）极为罕见。在此，我们描述一例50岁男性患者，其左小腿患有胆固醇性纤维组织细胞瘤。他的左小腿伸侧出现一个直径6毫米的角化过度结节，表面呈褐色。该病变在数年中逐渐发展，无愈合倾向。对肿瘤进行的皮肤活检显示，组织病理学结果与皮肤纤维瘤相符。有趣的是，病变中包含许多胆固醇裂隙，以及围绕它们的泡沫状组织细胞和多核巨细胞。他患有代谢综合征多年。据我们所知，这是首例关于代谢综合征患者发生胆固醇性纤维组织细胞瘤的报告。我们得出结论，代谢综合征引起的微环境改变以及高脂蛋白血症本身，可能在这一罕见病例的发病机制中起作用。
