Bednar tumor: report of a case with immunohistochemical and ultrastructural study

A slowly growing tumor in the right shoulder of a 38-year-old white male, which felt like a superficial cystic mass, was studied. The spindle cells, which represented the main component of the tumor, were arranged in a typical storiform pattern and were positive for CD34 and focally for CD117. The pigmented cells were mostly found at the center of the storiform whorls and were negative for S-100 protein and HMB-45. Ultrastructurally, the tumor consisted predominantly of nondescript mesenchymal spindle cells that resembled fibroblasts. The tumor cells blended into a loosely arranged stromal tissue background. The general appearance of pigmented cells was very similar to the nonpigmented spindle cells. The pigment appeared to be a mature form of melanin granules. The lack of premelanosomes, cell injections, basal lamina, and pinocytotic vesicles was inconsistent with a neural origin/neural differentiation hypothesis for this tumor.