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Rudolph Virchow discovered spindle-shaped cells called fibroblasts in 1858. Inactive fibroblasts, called fibrocytes, become activated by various stimuli, such as growth factors and inflammatory cytokines. Activated fibroblasts play a crucial role in wound healing, inflammation, formation of new blood vessels, and cancer progression. Uncontrolled activation of fibroblasts results in fibrosis, the excess deposition of fibrous tissue, which can lead to scarring and affect normal organs. This...

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Atypical fibroxanthoma: a selective review.

Alejandro A Gru1, Daniel J Santa Cruz

  • 1Department of Pathology & Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.

Seminars in Diagnostic Pathology
|January 19, 2013
PubMed
Summary
This summary is machine-generated.

Atypical fibroxanthoma is a type of skin tumor often found in older adults, particularly on sun-damaged head and neck areas. This review details its histomorphology, subtypes, and differential diagnosis for better understanding of these mesenchymal neoplasms.

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Area of Science:

  • Dermatology
  • Pathology
  • Oncology

Background:

  • Head and neck skin exhibits a high incidence of cutaneous tumors relative to its surface area.
  • Squamous and basal cell carcinomas are the most prevalent skin cancers, often linked to chronic sun exposure.
  • Atypical fibroxanthoma (AFX) is a group of typically indolent cutaneous tumors affecting older adults.

Purpose of the Study:

  • To review atypical fibroxanthoma, focusing on its histomorphology, various subtypes, and immunophenotypic profile.
  • To discuss the differential diagnosis of atypical fibroxanthoma in the context of head and neck cutaneous neoplasms.
  • To explore the potential relationship between atypical fibroxanthoma and squamous cell carcinoma.

Main Methods:

  • Histological examination of atypical fibroxanthoma, noting characteristic cellular features such as pleomorphism and mitotic activity.
  • Analysis of immunophenotypic profiles to understand the mesenchymal nature of these tumors.
  • Review of described histological variants, including clear-cell, desmoplastic, granular, and myxoid subtypes.

Main Results:

  • Atypical fibroxanthoma presents with a characteristic histology including fusiform, epithelioid, and pleomorphic cells, frequent mitoses, and occasional intracytoplasmic lipidization.
  • Multiple histological variants of AFX exist, demonstrating diverse presentations.
  • These tumors consistently exhibit a mesenchymal immunophenotype.

Conclusions:

  • Atypical fibroxanthoma is a distinct cutaneous neoplasm with a mesenchymal immunophenotype, presenting with varied histomorphology and subtypes.
  • Understanding its histological features and immunophenotype is crucial for accurate diagnosis and differentiation from other skin tumors.
  • Further research may clarify its proposed origin as a dedifferentiated squamous cell carcinoma variant.