Document Detail

Haemorrhagic dermatomyofibroma (plaque-like dermal fibromatosis): clinicopathological and immunohistochemical analysis of three cases resembling plaque-stage Kaposi's sarcoma.
MedLine Citation:
PMID:  12786896     Owner:  NLM     Status:  MEDLINE    
AIMS: Dermatomyofibroma (plaque-like dermal fibromatosis) represents a distinct clinicopathological entity in the spectrum of cutaneous mesenchymal neoplasms showing a myofibroblastic line of differentiation. These benign neoplasms occur frequently, but not exclusively, in young women, and the shoulder girdle as well as the upper trunk are common locations. Histologically, dermatomyofibroma is characterized by a plaque-like proliferation of cytologically bland spindle-shaped tumour cells containing an ill-defined, pale eosinophilic cytoplasm and elongated, neuroid nuclei. Neoplastic cells are arranged in bundles and fascicles orientated parallel to the skin surface, adnexal structures are spared and elastic fibres are increased and fragmented. Immunohistochemically, tumour cells express vimentin and variably muscle actin and alpha-smooth muscle actin, but are negative for desmin, CD34, S100, and epithelial markers. The main differential diagnosis includes hypertrophic scar, dermatofibroma (fibrous histiocytoma), pilar leiomyoma, neurofibroma, adult myofibromatosis, extra-abdominal fibromatosis and plaque-stage dermatofibrosarcoma protuberans. METHODS AND RESULTS: We report three cases of dermatofibroma arising in male patients aged 31, 36, and 47 years on the thigh, chest wall and back, respectively. All lesions were completely excised and no local recurrence has been reported. Histologically, the neoplasms showed classical features of dermatomyofibroma; however, in addition abundant extravasated erythrocytes, scattered inflammatory cells, numerous capillaries, and sieve- and slit-like spaces, features resembling plaque-stage Kaposi's sarcoma, were noted. In none of the cases did spindled tumour cells stain positively for CD34, and HHV8 was not detected by polymerase chain reaction. CONCLUSIONS: The reported cases widen the clinicopathological spectrum of dermatomyofibroma and emphasize plaque-stage Kaposi's sarcoma as an additional differential diagnosis.
T Mentzel; H Kutzner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Histopathology     Volume:  42     ISSN:  0309-0167     ISO Abbreviation:  Histopathology     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-05     Completed Date:  2004-01-22     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7704136     Medline TA:  Histopathology     Country:  England    
Other Details:
Languages:  eng     Pagination:  594-8     Citation Subset:  IM    
Dermatopathologisches Gemeinschaftslabor, Friedrichshafen, Germany.
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MeSH Terms
Diagnosis, Differential
Hemorrhage / pathology*
Histiocytoma, Benign Fibrous / chemistry,  pathology*,  surgery
Leiomyoma / chemistry,  pathology*,  surgery
Middle Aged
Sarcoma, Kaposi / pathology*
Skin Neoplasms / chemistry,  pathology*,  surgery
Treatment Outcome
Tumor Markers, Biological
Reg. No./Substance:
0/Tumor Markers, Biological

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