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Hemangiopericytoma-like dermatofibroma with mast cells
Jose Aneiros-Fernandez1, Salvador Arias-Santiago, Maria Jose Espiñeira-Carmona
1Department of Pathology, University Hospital, Granada, Spain. janeirosf@hotmail.com
Insights
This study describes a rare hemangiopericytoma-like dermatofibroma in an elderly patient. The unusual vascular pattern and abundant mast cells present diagnostic challenges for spindle cell neoplasms.
Area of Science:
- Dermatopathology
- Surgical Pathology
Background:
- Dermatofibromas are common benign skin neoplasms.
- Unusual histological variants can mimic other spindle cell tumors, posing diagnostic challenges.
Observation:
- An 82-year-old patient presented with a nodular dermal growth on the right shoulder.
- Microscopic examination revealed a dermatofibroma with a hemangiopericytoma-like vascular pattern.
- Abundant mast cells (tryptase and CD117 positive) were noted within the neoplasm.
Findings:
- Neoplastic cells were positive for CD68 and Factor XIIIa, and negative for CD34.
- The vascular component featured staghorn channels and endothelial-lined structures.
- The presence of numerous mast cells is an infrequent observation in this entity.
Implications:
- This case highlights the importance of considering unusual presentations of dermatofibroma.
- The differential diagnosis for spindle cell neoplasms should include this variant.
- Abundant mast cells may contribute to the distinctive vascular morphology observed.
Abstract:
We report an unusual case of hemangiopericytoma-like dermatofibroma in the right shoulder of an 82-year-old patient with a well-defined nodular growth located in the dermis. Microscopic study revealed a band of haphazardly arranged cells with a vascular component of gaping, simple, endothelial-lined vascular structures with intervening postcapillary venules and capillary-sized slit-like "staghorn" vascular channels filled with erythrocytes; abundant mast cells were also observed. The neoplasm cells were positive for CD68 and Factor XIIIA and negative for CD34. Few data have been published on the presence of abundant mast cells (tryptase and CD117 positive) in these neoplasm. The differential diagnosis of this entity should consider other spindle cell neoplasm, including hemangiopericytoma/solitary fibrous tumor, dermatofibrosarcoma protuberans, myopericytoma, angioleiomyoma, amelanotic melanoma, pecoma, and benign and malignant peripheral nerve tumors. We present an infrequent case of dermatofibroma with a vascular pattern resembling hemangiopericytoma and the presence of abundant mast cells, which may be responsible for this vascular component.
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