Peters M S, Reiman H M, Muller S A
J Cutan Pathol. 1985 Dec;12(6):476-85. doi: 10.1111/j.1600-0560.1985.tb00446.x.
Extraskeletal Ewing's sarcoma has been recognized as being histologically indistinguishable from Ewing's sarcoma of bone. Although the occurrence of extraosseous Ewing's sarcoma in deep soft tissues has been well described, such cutaneous lesions are rare. We report the clinical history, histopathologic findings, and results of ultrastructural study of this rare variant occurring in a 12-year-old girl. She presented with a dermal and subcutaneous tumor of the left third toe, without osseous involvement. The lesion was composed of masses of round-oval cells, with perilobular fibrosis, focal hemorrhage, ill-defined pale cytoplasm containing glycogen, and absent pericellular reticulin. Ultrastructural study showed a monotonous cell population, with focal thickening of apposing membranes, high nuclear/cytoplasmic ratio, copious intracytoplasmic glycogen, and paucity of organelles except mitochondria. We present this case along with discussion of the literature and problems concerning differential diagnosis of small cell malignancies in the skin.
骨外尤因肉瘤在组织学上已被认为与骨尤因肉瘤无法区分。尽管深部软组织中骨外尤因肉瘤的发生已有详尽描述，但此类皮肤病变却很罕见。我们报告了一名12岁女孩发生的这种罕见变异型的临床病史、组织病理学发现及超微结构研究结果。她表现为左足第三趾的真皮和皮下肿瘤，无骨质受累。病变由圆形至椭圆形细胞团组成，伴有小叶周围纤维化、局灶性出血，淡染的细胞质含糖原且界限不清，细胞周围网状纤维缺乏。超微结构研究显示细胞群体单一，相邻细胞膜局灶性增厚，核质比高，胞质内糖原丰富，除线粒体外在细胞器稀少。我们展示此病例并讨论相关文献以及皮肤小细胞恶性肿瘤的鉴别诊断问题。
