Servicio de Dermatología, Hospital Universitario Lucus Augusti, Lugo, España.
Servicio de Dermatología, Complejo Hospitalario Universitario A Coruña, A Coruña, España.
Actas Dermosifiliogr (Engl Ed). 2021 May;112(5):392-405. doi: 10.1016/j.ad.2020.11.018. Epub 2020 Dec 7.
The relation between atypical fibroxanthoma and pleomorphic dermal sarcoma has led to confusion and debate in the literature. Both tumors present on sun-exposed skin, typically on the head and neck, in patients of advanced age. Both are comprised of a variable mix of histiocytoid, spindle, epithelioid, and/or giant multinucleated cells with pleomorphic nuclei. No immunohistochemical diagnostic techniques have emerged to distinguish these tumors. Diagnosis is by exclusion. Histologically, atypical fibroxanthoma is seen as a well-circumscribed dermal nodule but there will be no evidence of extensive subcutaneous invasion, tumor necrosis, or lymphovascular or perineural invasion. Therefore, if any of the aforementioned features is present, the diagnosis would be pleomorphic dermal sarcoma. This narrative review of the literature aims to identify the distinguishing and overlapping histopathologic features of these 2 tumors as they have been described in case series.
非典型纤维黄色瘤与多形性真皮肉瘤之间的关系在文献中引起了混淆和争议。这两种肿瘤均发生于暴露于阳光的皮肤，通常发生于头部和颈部，患者年龄较大。它们均由不同比例的组织细胞样、梭形、上皮样和/或巨多核细胞组成，核具有多形性。目前尚无免疫组织化学诊断技术可用于区分这些肿瘤。诊断是通过排除法。组织学上，非典型纤维黄色瘤表现为界限清楚的真皮结节，但无广泛皮下浸润、肿瘤坏死或血管淋巴管或神经周围浸润的证据。因此，如果存在上述任何特征，则诊断为多形性真皮肉瘤。本文献综述旨在确定这两种肿瘤在病例系列中描述的具有鉴别意义和重叠的组织病理学特征。
