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CD34-positive superficial myxofibrosarcoma: a potential diagnostic pitfall.
Steven C Smith1, Ann A Poznanski, Douglas R Fullen
1Department of Pathology, University of Michigan, Ann Arbor, MI 48109-0602, USA.
Journal of Cutaneous Pathology
|April 23, 2013
Summary
CD34 positivity is common in superficial myxofibrosarcoma (MFS), often mimicking benign tumors. Recognizing this CD34 reactivity is crucial for accurate MFS diagnosis, especially in limited biopsy samples.
Area of Science:
- Oncology
- Dermatopathology
- Surgical Pathology
Background:
- Myxofibrosarcoma (MFS) commonly affects elderly individuals, typically in the extremities.
- Superficial MFS can present in dermal and subcutaneous tissues, potentially mimicking benign lesions in small biopsies.
- Limited case series have evaluated CD34 expression in cutaneous MFS.
Purpose of the Study:
- To assess the prevalence of CD34 reactivity in superficial myxofibrosarcoma.
- To determine if CD34 positivity can aid in differentiating MFS from benign mimics.
- To inform diagnostic interpretation of MFS in limited biopsy specimens.
Main Methods:
- Systematic review of MFS resection specimens from a single institution.
- Selection of superficial MFS cases with potential diagnostic ambiguity in limited biopsies.
- Immunohistochemical staining for CD34 and tabulation of clinicopathologic features.
Main Results:
- Over 5 years, 56 MFS cases were reviewed, identifying 8 superficial cases for analysis.
- CD34 positivity was observed in 50% (4 of 8) of superficial MFS cases, with diffuse staining in spindled cells.
- The remaining cases showed no or equivocal/rare CD34 staining.
Conclusions:
- CD34 positivity is a prevalent finding in superficial myxofibrosarcoma.
- CD34 reactivity should not be misinterpreted as evidence against MFS, particularly when considering benign entities.
- Awareness of CD34 expression aids in the accurate diagnosis of MFS.