Departments of Plastic and Reconstructive Surgery, Nippon Medical School Musashi-Kosugi Hospital, Kanagawa, Japan.
Dermatology, Nippon Medical School Musashi-Kosugi Hospital, Kanagawa, Japan.
Am J Clin Pathol. 2024 Mar 1;161(3):232-244. doi: 10.1093/ajcp/aqad136.
Aneurysmal dermatofibroma (ADF) and hemosiderotic dermatofibroma (HDF) are rare variants of dermatofibroma (DF) characterized by distinct histologic features. While HDF is traditionally considered a precursor to ADF, supporting evidence is limited, and the etiology remains unclear. A retrospective analysis of 2128 DF cases (2016-2019) was conducted to investigate the clinicopathologic characteristics of ADF, HDF, and other DFs.
Histopathologically diagnosed DF cases were examined for ADF and HDF. Univariate analyses were performed to compare clinicopathologic features.
Among the cases, 168 (7.9%) were ADF and 29 (1.4%) were HDF. Aneurysmal dermatofibroma and HDF shared several common characteristics, including lower occurrence in females, larger size, and increased cellularity (all P < .0001). Notably, 29% of ADFs lacked hemosiderin deposition. Aneurysmal dermatofibroma primarily manifested on exposed areas (face and forearm, both P < .001). In contrast, 41% of HDFs occurred on the lower leg (P = .018), and all lower leg HDFs exhibited signs of venous stasis, distinguishing them from other HDFs (P < .0001).
Our findings indicate a potential close relationship between ADF and HDF. Contrary to conventional beliefs, we also presented the possibility of ADF progressing into HDFs. Physical trauma may induce ADF, and HDFs may emerge from ADFs in conjunction with venous stasis in the lower extremities.
动脉瘤样皮肤纤维瘤（ADF）和含铁血黄素沉积性皮肤纤维瘤（HDF）是皮肤纤维瘤（DF）的罕见变异型，具有独特的组织学特征。虽然 HDF 传统上被认为是 ADF 的前体，但支持证据有限，其病因仍不清楚。对 2128 例 DF 病例（2016-2019 年）进行回顾性分析，以研究 ADF、HDF 和其他 DF 的临床病理特征。
对组织病理学诊断为 DF 的病例进行 ADF 和 HDF 检查。采用单因素分析比较临床病理特征。
病例中，ADF 为 168 例（7.9%），HDF 为 29 例（1.4%）。ADF 和 HDF 具有一些共同特征，包括女性发病率较低、体积较大和细胞增多（均 P <.0001）。值得注意的是，29%的 ADF 缺乏含铁血黄素沉积。ADF 主要发生在暴露部位（面部和前臂，均 P <.001）。相比之下，41%的 HDF 发生在小腿（P =.018），所有小腿 HDF 均有静脉淤滞迹象，与其他 HDF 不同（P <.0001）。
我们的研究结果表明 ADF 和 HDF 之间可能存在密切关系。与传统观点相反，我们还提出了 ADF 进展为 HDF 的可能性。外伤可能会诱发 ADF，而 HDF 可能是由下肢静脉淤滞引起的 ADF 演变而来。
