Santa Cruz D J, Kyriakos M
Cancer. 1981 Apr 15;47(8):2053-61. doi: 10.1002/1097-0142(19810415)47:8<2053::aid-cncr2820470825>3.0.co;2-a.
Seventeen cases are reported of a variety of cutaneous fibrous histiocytoma, which we have designated as aneurysmal ("angiomatoid") fibrous histiocytoma. These lesions differ from the classical cutaneous fibrous histiocytoma in both their clinical presentation and pathologic features. Clinically, they may be larger than the usual cutaneous fibrous histiocytoma, are blue, black, or dark red, and have a cystic consistency. They are most commonly located on the extremities and may be associated with symptoms of pain and rapid growth. The clinical diagnosis of fibrous histiocytoma is seldom considered in the differential diagnosis, which may include malignant melanoma, hemangioma, neurofibroma, and nonspecific cyst. Histologically, the lesions are characterized by the presence of large, blood-filled tissue spaces, which, at times, account for up to one half their size. These spaces lack an endothelial lining, being surrounded and lined by histiocytes, many of which contain hemosiderin pigment, fibroblasts, and foam cells. The solid portions of the tumor have the usual features of a cutaneous fibrous histiocytoma. This "angiomatoid" lesion is closely allied to what has been termed "hemosiderin histiocytoma," which appears to be a precursor stage in its formation. The presence of extravasated erythrocytes in combination with a spindle-cell stroma may lead to an erroneous diagnosis of Kaposi's sarcoma. This cutaneous tumor has architectural and cytologic similarities to its malignant soft tissue counterpart recently described as angiomatoid malignant fibrous histiocytoma. However, unlike the latter, the cutaneous lesion is benign and lacks the prominent inflammatory infiltrate, pleomorphic appearance, and systemic manifestations of its soft tissue counterpart. The distinctive clinical and pathologic features of the cutaneous lesion serve to separate it as a specific variant of the cutaneous fibrous histiocytomas.
报告了17例各种皮肤纤维组织细胞瘤，我们将其命名为动脉瘤样（“血管样”）纤维组织细胞瘤。这些病变在临床表现和病理特征上均与经典的皮肤纤维组织细胞瘤不同。临床上，它们可能比通常的皮肤纤维组织细胞瘤更大，呈蓝色、黑色或暗红色，质地呈囊性。它们最常见于四肢，可能伴有疼痛和快速生长的症状。在鉴别诊断中很少考虑纤维组织细胞瘤的临床诊断，鉴别诊断可能包括恶性黑色素瘤、血管瘤、神经纤维瘤和非特异性囊肿。组织学上，病变的特征是存在大的、充满血液的组织间隙，有时这些间隙占其大小的一半。这些间隙缺乏内皮衬里，被组织细胞包围并衬里，其中许多组织细胞含有含铁血黄素色素、成纤维细胞和泡沫细胞。肿瘤的实性部分具有皮肤纤维组织细胞瘤的常见特征。这种“血管样”病变与所谓的“含铁血黄素组织细胞瘤”密切相关，后者似乎是其形成的前期阶段。外渗红细胞与梭形细胞基质的存在可能导致对卡波西肉瘤的错误诊断。这种皮肤肿瘤在结构和细胞学上与其最近被描述为血管样恶性纤维组织细胞瘤的恶性软组织对应物相似。然而，与后者不同的是，皮肤病变是良性的，缺乏其软组织对应物的显著炎症浸润、多形性外观和全身表现。皮肤病变独特的临床和病理特征使其作为皮肤纤维组织细胞瘤的一种特定变体而得以区分。
