Sato Chikako, Takahashi Oh, Ogata Sho, Fujisaku Mai, Edo Hiromi, Sato Kimiya, Susa Michiro, Matsukuma Susumu
Department of Laboratory Medicine, National Defense Medical College Hospital, Saitama, JPN.
Department of Pathology and Laboratory Medicine, National Defense Medical College, Saitama, JPN.
Cureus. 2024 Oct 30;16(10):e72695. doi: 10.7759/cureus.72695. eCollection 2024 Oct.
Myopericytoma is a rare perivascular myoid neoplasm that typically arises in the dermis or subcutaneous tissue, with an intravascular variant also reported. We present a case of an elderly man with a subcutaneous nodule in his lower leg that had persisted for four decades, accompanied by pain in the last several years. Imaging revealed a 20-mm elongated subcutaneous nodule along with a similar intraosseous lesion in the ipsilateral fibula. Histologically, the subcutaneous lesion appeared as a multinodular, vascular-rich tumor, characterized by myoid spindle cells arranged concentrically around vessels of varying sizes. These myoid cells were immunoreactive for smooth muscle markers. Additionally, the tumor exhibited both a feeding artery and a draining vein, mimicking a vascular malformation. Another portion of the subcutaneous nodule was surrounded by a venous-type vascular structure. These findings supported a diagnosis of intravascular myopericytoma, with its extension possibly being myopericytomatosis.
肌周细胞瘤是一种罕见的血管周围肌样肿瘤，通常发生于真皮或皮下组织，也有血管内型的报道。我们报告一例老年男性患者，其小腿皮下结节持续存在40年，最近几年伴有疼痛。影像学检查显示一个20毫米长的皮下结节，同侧腓骨还有一个类似的骨内病变。组织学上，皮下病变表现为多结节、富含血管的肿瘤，其特征为肌样梭形细胞围绕不同大小的血管呈同心圆排列。这些肌样细胞对平滑肌标志物呈免疫反应。此外，肿瘤有一条供血动脉和一条引流静脉，类似血管畸形。皮下结节的另一部分被静脉型血管结构包绕。这些发现支持血管内肌周细胞瘤的诊断，其扩展可能为肌周细胞瘤病。
