Dermatofibroma: Difference between revisions

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{{ Infobox diagnosis

| Name = {{PAGENAME}}

| Image =

| Image = SkinTumors-P9280848.jpg

| Width =

| Caption =

| Caption = Dermatofibroma. [[H&E stain]].

| Micro = ~~Prominent~~ fibrous bundles - especially at the edge of the lesion ("collagen-trapping"), loss of adnexal structures, +/-"dirty fingers" ([[acanthosis]], basal keratinocyte hyperpigmentation)

| Micro = prominent fibrous bundles - especially at the edge of the lesion ("collagen-trapping"), loss of adnexal structures, +/-"dirty fingers" ([[acanthosis]], basal keratinocyte hyperpigmentation)

| Subtypes = ~~Cellular~~, deep penetrating, lipidized, epithelioid cell histiocytoma, fibrotic, aneurysmal, granular cell dermatofibroma, dermatofibroma with monster cells

| Subtypes = cellular, deep penetrating, lipidized, epithelioid cell histiocytoma, fibrotic, aneurysmal, granular cell dermatofibroma, dermatofibroma with monster cells

| LMDDx =

| LMDDx = [[DFSP]], [[neurofibroma]], [[blue nevus]], [[melanoma]], esp. desmoplastic neurotropic-type, [[fibromatosis]]

| Stains =

| IHC =

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| Gross =

| Grossing =

| Site =

| Site = [[skin]]

| Assdx =

| Syndromes =

| Clinicalhx = previous trauma

| Signs =

| Symptoms =

| Prevalence =

| Prevalence = common

| Bloodwork =

| Rads =

| Endoscopy =

| Prognosis =

| Prognosis = benign

| Other =

| ClinDDx =

}}

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==General==

*~~Reactive~~ process -~~- it is~~ ''not'' a neoplasm.

*Classically considered a reactive process - ''not'' a neoplasm.

*Usually associated with previous trauma.

**In women... usually legs.

*Multiple dermatofibromas are described in association [[Down syndrome]].<ref name=pmid36219648>{{cite journal |authors=Zimmerman TJ, George SJ |title=Multiple Eruptive Dermatofibromas Associated With Down Syndrome |journal=Cutis |volume=110 |issue=2 |pages=E21–E23 |date=August 2022 |pmid=36219648 |doi=10.12788/cutis.0600 |url=}}</ref><ref name=pmid23879455>{{cite journal |authors=Lamb RC, Gangopadhyay M, MacDonald A |title=Multiple dermatofibromas in Down syndrome |journal=Int J Dermatol |volume=53 |issue=4 |pages=e274–5 |date=April 2014 |pmid=23879455 |doi=10.1111/ijd.12037 |url=}}</ref>

==Microscopic==

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*[[Melanoma]], esp. desmoplastic neurotropic-type.

*[[Fibromatosis]].

*[[Dermal scar]].

Images:

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*[http://www.pacificderm.org/newsflashcpcapril04.html DF - several images (pacificderm.org)].

*[http://biocare.net/products/antibodies/f/357/ DF stained with factor XIIIa (biocare.net)].

*[http://dermpathexpert.com/imagelib/sitebuilder/misc/show_image.html?linkedwidth=560&linkpath=http://dermpathexpert.com/sitebuildercontent/sitebuilderpictures/webassets/.pond/SB073911DermatofibromaFactorXIIIa40x.jpg.w560h422.jpg&target=_self&title=Dermatofibroma DF stained with factor XIIIa (dermpathexpert.com)].<ref>URL: [http://dermpathexpert.com/id8.html http://dermpathexpert.com/id8.html]. Accessed on: 19 July 2013.</ref>

===Subtypes===

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*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?f=0&sort=0&s=20080802171836877 Cellular dermatofibroma (surgicalpathologyatlas.com)].

*[http://www.dermpedia.org/node/2292 Cellular dermatofibroma (dermpedia.org)].<ref>URL: [http://www.dermpedia.org/case/cellular-dermatofibroma-mimicking-dermatofibrosarcoma-protuberans# http://www.dermpedia.org/case/cellular-dermatofibroma-mimicking-dermatofibrosarcoma-protuberans#]. Accessed on: 4 February 2012.</ref>

===Epithelioid cell histiocytoma===

Features:

*Epithelioid cells.

*No lesional cells in epidermis.

DDx:

*[[Melanocytic lesions]] - esp. [[malignant melanoma]].

==IHC==

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**Usually negative in DFSP.

**There is not much literature on D2-40 in this context. Molecular work on the protein (podoplanin) the antibody is directed at has shown it is present in DFSP.<ref name=pmid21234520>{{Cite journal | last1 = Xu | first1 = Y. | last2 = Ogose | first2 = A. | last3 = Kawashima | first3 = H. | last4 = Hotta | first4 = T. | last5 = Ariizumi | first5 = T. | last6 = Li | first6 = G. | last7 = Umezu | first7 = H. | last8 = Endo | first8 = N. | title = High-level expression of podoplanin in benign and malignant soft tissue tumors: immunohistochemical and quantitative real-time RT-PCR analysis. | journal = Oncol Rep | volume = 25 | issue = 3 | pages = 599-607 | month = Mar | year = 2011 | doi = 10.3892/or.2011.1141 | PMID = 21234520 }}</ref>

Image:

*[http://pathinfo.wikia.com/wiki/File:CD34.DFSP.100x.jpg DFSP - CD34 (wikia.com)].

==Sign out==

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</pre>

<pre>

SKIN LESION, LEFT UPPER ARM, EXCISION:

- DERMATOFIBROMA.

COMMENT:

The histologic impression is supported by immunostains; a CD34 immunostain

is negative and a factor XIIIa immunostain is weakly positive.

</pre>

===Micro===

The sections show skin with bland spindle cells interspersed between fibrous bundles.

@@ Line 1: / Line 1: @@
 {{ Infobox diagnosis
 | Name       = {{PAGENAME}}
-| Image      =
+| Image      = SkinTumors-P9280848.jpg
 | Width      =
-| Caption    =
+| Caption    = Dermatofibroma. [[H&E stain]].
-| Micro      = Prominent fibrous bundles - especially at the edge of the lesion ("collagen-trapping"), loss of adnexal structures, +/-"dirty fingers" ([[acanthosis]], basal keratinocyte hyperpigmentation)
+| Micro      = prominent fibrous bundles - especially at the edge of the lesion ("collagen-trapping"), loss of adnexal structures, +/-"dirty fingers" ([[acanthosis]], basal keratinocyte hyperpigmentation)
-| Subtypes   = Cellular, deep penetrating, lipidized, epithelioid cell histiocytoma, fibrotic, aneurysmal, granular cell dermatofibroma, dermatofibroma with monster cells
+| Subtypes   = cellular, deep penetrating, lipidized, epithelioid cell histiocytoma, fibrotic, aneurysmal, granular cell dermatofibroma, dermatofibroma with monster cells
-| LMDDx      =
+| LMDDx      = [[DFSP]], [[neurofibroma]], [[blue nevus]], [[melanoma]], esp. desmoplastic neurotropic-type, [[fibromatosis]]
 | Stains     =
 | IHC        =
@@ Line 14: / Line 14: @@
 | Gross      =
 | Grossing   =
-| Site       =
+| Site       = [[skin]]
 | Assdx      =
 | Syndromes  =
+| Clinicalhx = previous trauma
 | Signs      =
 | Symptoms   =
-| Prevalence =
+| Prevalence = common
 | Bloodwork  =
 | Rads       =
 | Endoscopy  =
-| Prognosis  =
+| Prognosis  = benign
 | Other      =
 | ClinDDx    =
 }}
@@ Line 30: / Line 31: @@
 ==General==
-*Reactive process -- it is ''not'' a neoplasm.
+*Classically considered a reactive process - ''not'' a neoplasm.
 *Usually associated with previous trauma.
 **In women... usually legs.
+*Multiple dermatofibromas are described in association [[Down syndrome]].<ref name=pmid36219648>{{cite journal |authors=Zimmerman TJ, George SJ |title=Multiple Eruptive Dermatofibromas Associated With Down Syndrome |journal=Cutis |volume=110 |issue=2 |pages=E21–E23 |date=August 2022 |pmid=36219648 |doi=10.12788/cutis.0600 |url=}}</ref><ref name=pmid23879455>{{cite journal |authors=Lamb RC, Gangopadhyay M, MacDonald A |title=Multiple dermatofibromas in Down syndrome |journal=Int J Dermatol |volume=53 |issue=4 |pages=e274–5 |date=April 2014 |pmid=23879455 |doi=10.1111/ijd.12037 |url=}}</ref>
 ==Microscopic==
@@ Line 50: / Line 52: @@
 *[[Melanoma]], esp. desmoplastic neurotropic-type.
 *[[Fibromatosis]].
+*[[Dermal scar]].
 Images:
@@ Line 56: / Line 59: @@
 *[http://www.pacificderm.org/newsflashcpcapril04.html DF - several images (pacificderm.org)].
 *[http://biocare.net/products/antibodies/f/357/ DF stained with factor XIIIa (biocare.net)].
+*[http://dermpathexpert.com/imagelib/sitebuilder/misc/show_image.html?linkedwidth=560&linkpath=http://dermpathexpert.com/sitebuildercontent/sitebuilderpictures/webassets/.pond/SB073911DermatofibromaFactorXIIIa40x.jpg.w560h422.jpg&target=_self&title=Dermatofibroma DF stained with factor XIIIa (dermpathexpert.com)].<ref>URL: [http://dermpathexpert.com/id8.html http://dermpathexpert.com/id8.html]. Accessed on: 19 July 2013.</ref>
 ===Subtypes===
@@ Line 75: / Line 79: @@
 *[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?f=0&sort=0&s=20080802171836877 Cellular dermatofibroma (surgicalpathologyatlas.com)].
 *[http://www.dermpedia.org/node/2292 Cellular dermatofibroma (dermpedia.org)].<ref>URL: [http://www.dermpedia.org/case/cellular-dermatofibroma-mimicking-dermatofibrosarcoma-protuberans#  http://www.dermpedia.org/case/cellular-dermatofibroma-mimicking-dermatofibrosarcoma-protuberans#]. Accessed on: 4 February 2012.</ref>
+===Epithelioid cell histiocytoma===
+Features:
+*Epithelioid cells.
+*No lesional cells in epidermis.
+DDx:
+*[[Melanocytic lesions]] - esp. [[malignant melanoma]].
 ==IHC==
@@ Line 87: / Line 99: @@
 **Usually negative in DFSP.
 **There is not much literature on D2-40 in this context. Molecular work on the protein (podoplanin) the antibody is directed at has shown it is present in DFSP.<ref name=pmid21234520>{{Cite journal  | last1 = Xu | first1 = Y. | last2 = Ogose | first2 = A. | last3 = Kawashima | first3 = H. | last4 = Hotta | first4 = T. | last5 = Ariizumi | first5 = T. | last6 = Li | first6 = G. | last7 = Umezu | first7 = H. | last8 = Endo | first8 = N. | title = High-level expression of podoplanin in benign and malignant soft tissue tumors: immunohistochemical and quantitative real-time RT-PCR analysis. | journal = Oncol Rep | volume = 25 | issue = 3 | pages = 599-607 | month = Mar | year = 2011 | doi = 10.3892/or.2011.1141 | PMID = 21234520 }}</ref>
+Image:
+*[http://pathinfo.wikia.com/wiki/File:CD34.DFSP.100x.jpg DFSP - CD34 (wikia.com)].
 ==Sign out==
@@ Line 94: / Line 109: @@
 </pre>
+<pre>
+SKIN LESION, LEFT UPPER ARM, EXCISION:
+- DERMATOFIBROMA.
+COMMENT:
+The histologic impression is supported by immunostains; a CD34 immunostain
+is negative and a factor XIIIa immunostain is weakly positive.
+</pre>
 ===Micro===
 The sections show skin with bland spindle cells interspersed between fibrous bundles.

Dermatofibroma: Difference between revisions

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