Indeterminate fibrohistiocytic lesions of the skin: Is there a spectrum between dermatofibroma and dermatofibrosarcoma protuberans?

Marcelo G. Horenstein, Victor Prieto, J. Dean Nuckols, James L. Burchette, Christopher R. Shea

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Routine histology and immunohistochemistry can usually distinguish dermatofibroma (DF) and dermatofibrosarcoma protuberans (DFSP). DF generally expresses factor XIIIa whereas DFSP generally expresses CD34. The authors report 10 cutaneous fibrohistiocytic lesions combining clinical, histologic, and immunohistochemical features of both DF and DFSP. The lesions had an average size of 1.2 cm (range, 0.4-2.7 cm), and occurred on the trunk (n = 6), extremities (n = 3), and face (n = 1) of four men and six women (average age, 30.6 yrs; age range, 15-50 yrs). Eight lesions exhibited acanthosis and densely cellular fascicles with focal storiform areas. All had keloidal collagen, infiltrated the subcutis in a honeycomb pattern, and had low mitotic counts (0 to 4 mitoses per square millimeter). All were diffusely immunoreactive for factor XIIIa (30%-60% of the neoplastic cells) as well as CD34 (20%70%). This series raises the possibility of a biologic spectrum between DF and DFSP; however, double-immunolabeling studies showed no notable coexpression of factor XIIIa and CD34 by individual cells, suggesting coexistence of two different cellular populations. After an average follow up of 22.3 months (range, 10-46 mos) in six cases, a single recurrence was documented. The ambiguous histologic features and the potential for local recurrence suggest that performing a complete excision may be prudent in these diagnostically indeterminate lesions.

Original languageEnglish (US)
Pages (from-to)996-1003
Number of pages8
JournalAmerican Journal of Surgical Pathology
Volume24
Issue number7
DOIs
StatePublished - Jul 1 2000

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Dermatofibrosarcoma
Benign Fibrous Histiocytoma
Factor XIIIa
Skin
Recurrence
Mitosis
Histology
Collagen
Extremities
Immunohistochemistry
Population

Keywords

  • CD34
  • Dermatofibroma
  • Dermatofibrosarcoma
  • Factor XIIIa
  • Fibrohistiocytic
  • Immunohistochemistry

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Cite this

Indeterminate fibrohistiocytic lesions of the skin : Is there a spectrum between dermatofibroma and dermatofibrosarcoma protuberans? / Horenstein, Marcelo G.; Prieto, Victor; Nuckols, J. Dean; Burchette, James L.; Shea, Christopher R.

In: American Journal of Surgical Pathology, Vol. 24, No. 7, 01.07.2000, p. 996-1003.

Research output: Contribution to journalArticle

Horenstein, Marcelo G. ; Prieto, Victor ; Nuckols, J. Dean ; Burchette, James L. ; Shea, Christopher R. / Indeterminate fibrohistiocytic lesions of the skin : Is there a spectrum between dermatofibroma and dermatofibrosarcoma protuberans?. In: American Journal of Surgical Pathology. 2000 ; Vol. 24, No. 7. pp. 996-1003.
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