PMC5941799_01
(a) Punch biopsy reveals a spindle cell lesion infiltrating the dermis (H&E, 40x); (b) (H&E, 200x).
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fig1
A punch biopsy of this new lesion revealed sheets of polygonal and pleomorphic atypical cells with a focal storiform architecture, as well as abundant necrosis and increased mitotic activity (Figure 1).
Immunohistochemistry was positive for (a) CD 163+, (b) CD14+, and (c) CD4+. CD163 and CD14 are expressed on macrophages, while CD4 is expressed on other cells, such as helper T-cells; CD4 is also expressed on monocytes/macrophages. Immunohistochemistry was negative for (d) CD34. CD34 negativity indicates that this neoplasm is not a myeloid sarcoma.
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fig2
On immunohistochemical (IHC) stain examination, the neoplastic cells were reactive only for CD163, CD14, and CD4 (Figure 2).