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m (→DFSP) |
(→PUS) |
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Solar elastosis.<br> | Solar elastosis.<br> | ||
== PUS == | == PUS/AFX == | ||
===Microscopic=== | ===Microscopic=== | ||
The sections | The sections show an atypical spindle cell lesion in the deep dermis, with a storiform and fascicular pattern, marked nuclear pleomorphism and very high mitotic activity (129 mitoses / 10 HPF, field diameter 0.55 mm). The spindle cells have moderate-to-abundant partially vacuolated eosinophilic-to-amphophilic cytoplasm, ellipsoid-to-ovoid nuclei with coarse, irregular chromatin and, focally, nucleoli visible with the 10x objective. Atypical (malignant) multinucleated-cells are identified focally with abundant pale gray cytoplasm. | ||
Benign dense thick collagen bundles are seen in the superficial dermis with associated loss of the rete ridges (dermal scar). Suture material and (reactive) foreign body-type giant cells are also seen. | |||
Immunohistochemical staining show: | |||
-Positive staining of the tumour with: factor XIIIa (cytoplasmic), SMA (cytoplasmic - focal), WT1 (granular cytoplasmic - focal), CD10 (membranous/cytoplasmic), CD68 (cytoplasmic). | |||
-Negative staining of the tumour with: S100, p63, CD34, LMWK, CK5/6. | |||
===Final diagnosis=== | ===Final diagnosis=== | ||
Forearm lesion, left, re-excision:<br> | Forearm lesion, left, re-excision:<br> | ||
-PLEOMORPHIC UNDIFFERENTIATED SARCOMA OF THE SKIN (MALIGNANT FIBROUS HISTIOCYTOMA) WITH DEEP MARGIN FOCALLY POSITIVE, RE-EXCISION IS SUGGESTED.<br> | |||
-DERMAL SCAR. | |||
== DFSP == | == DFSP == |
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