Príncipe de Asturias University Hospital, Pathology Department, Spain.
Príncipe de Asturias University Hospital, Pathology Department, Spain.
Rev Esp Patol. 2024 Jul-Sep;57(3):217-224. doi: 10.1016/j.patol.2024.04.001. Epub 2024 May 20.
Hemosiderotic/aneurysmal variant of dermatofibroma (DF) is infrequent and may be misdiagnosed with malignant lesions. We report the case of a giant (7.6cm) subcutaneous hemosiderotic/aneurysmal DF (H/ADF) of the thigh in a 53-year-old female patient. Internal arterial and venous hypervascularity was seen by spectral Doppler ultrasound. Magnetic resonance image showed a discrete homogeneous hypointense in T1-weighted images (WI) and T2-WI mass, with hyperintense areas in fat-suppressed T2-WI. The histology revealed a monotonous fusocelular proliferation without atypia, positive for CD163, factor XIIIa and CD10. Widely distributed hemosiderin pigment and two blood-filled pseudovascular spaces lacking endothelial lining were present. H/ADF was diagnosed. The mass was removed but surgical margins were affected. The patient did not present local relapse or distant metastasis. H/ADF are unusual cutaneous soft tissue tumours that can be clinically, radiologically and histopathologically confused with malignant lesions such as melanomas, vascular lesions or sarcomas, especially in giant cases.
hemosiderotic/aneurysmal 变体的皮肤纤维瘤 (DF) 并不常见，可能会被误诊为恶性病变。我们报告了一例大腿巨大（7.6cm）皮下 hemosiderotic/aneurysmal DF (H/ADF) 的病例，该患者为 53 岁女性。频谱多普勒超声显示内部动脉和静脉呈高血流状态。磁共振成像 (MRI) 显示 T1 加权成像 (WI) 和 T2-WI 质量离散均匀的低信号，脂肪抑制 T2-WI 呈高信号区域。组织学显示为非典型的单一融合细胞增生，CD163、因子 XIIIa 和 CD10 阳性。广泛分布的含铁血黄素色素和两个无内皮衬里的充满血液的假血管空间。诊断为 H/ADF。切除了肿块，但手术边缘受到影响。患者未出现局部复发或远处转移。H/ADF 是罕见的皮肤软组织肿瘤，在临床上、影像学和组织病理学上可能与恶性病变（如黑色素瘤、血管病变或肉瘤）混淆，尤其是在巨大的情况下。
