Rekhi Bharat, Banerjee Devmalya, Gala Kunal, Gulia Ashish
Department of Surgical Pathology, Bone and Soft Tissue, Disease Management Group, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Department of Radiodiagnosis, Bone and Soft Tissue, Disease Management Group, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Indian J Pathol Microbiol. 2018 Jul-Sep;61(3):421-424. doi: 10.4103/IJPM.IJPM_221_17.
Superficial CD34-positive fibroblastic tumor is a recently described soft-tissue tumor entity. A 48 year-old-male presented with a gradually increasing soft-tissue mass in his right forearm of 2 years' duration, along with multiple subcutaneous soft-tissue nodular lesions, and reminiscent of lipomas over his body. He underwent a wide excision of his forearm mass. Microscopic sections showed a circumscribed tumor in the dermis and subcutaneous fat, composed of spindle cells, inflammatory cells, including lymphocytes, plasma cells, and eosinophils, along with interspersed markedly pleomorphic giant cells containing moderate-to-abundant "glassy" cytoplasm, vesicular nuclei, exhibiting prominent nucleoli, and intranuclear pseudoinclusions. There were no significant mitotic figures, areas of hemorrhage, necrosis, or pigment histiocytes. By immunohistochemistry, the tumor cells were diffusely positive for CD34 while negative for cytokeratin (CK), pan CK (AE1/AE3), S100 protein, CD30, and CD31. MIB1/Ki-67 was low and highlighted 4%-5% tumor nuclei. Diagnosis of superficial CD34-positive fibroblastic tumor was offered. Sections from the various resection margins were free of tumor. Postresection, the patient is alive with no evidence of disease for the past 8 months. This constitutes as one of the first case reports of this rare tumor entity from our country. Its diagnostic and treatment implications are discussed herewith.
浅表性CD34阳性成纤维细胞瘤是一种最近才被描述的软组织肿瘤实体。一名48岁男性,右前臂出现一个持续2年逐渐增大的软组织肿块,同时伴有多个皮下软组织结节性病变,身体其他部位类似脂肪瘤。他接受了前臂肿块的广泛切除。显微镜切片显示真皮和皮下脂肪中有一个边界清楚的肿瘤,由梭形细胞、炎症细胞(包括淋巴细胞、浆细胞和嗜酸性粒细胞)组成,其间散在着明显多形性的巨细胞,这些巨细胞含有中度至丰富的“玻璃样”细胞质、泡状核,核仁突出,并有核内假包涵体。未见明显的核分裂象、出血、坏死或色素组织细胞。免疫组化显示,肿瘤细胞CD34弥漫性阳性,而细胞角蛋白(CK)、泛CK(AE1/AE3)、S100蛋白、CD30和CD31均为阴性。MIB1/Ki-67较低,突出显示4%-5%的肿瘤细胞核。诊断为浅表性CD34阳性成纤维细胞瘤。各个切除边缘的切片均未见肿瘤。切除术后,患者存活,在过去8个月中无疾病证据。这是我国关于这种罕见肿瘤实体的首批病例报告之一。本文讨论了其诊断和治疗意义。