PMC4451677_01
Extraoral photograph showing facial asymmetry with a smooth surfaced swelling on the right lower side of the face
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F1
The tumor was hard and elastic and had a smooth surface [Figure 1].
MRI - STIR image showing hypointense areas suggestive of fat
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F2
T1 with small fatty component and cystic focus [Figure 2]. There was no fat plane with adjacent tongue suggesting its involvement. The right sub mandibular gland was abutted.
Hemangiopericytoma-like areas (black arrow) admixed with areas of mature adipocytes (red arrow) (H&E stain, x40)
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F3
HPC like areas admixed with mature adipocytes [Figure 3]. However, no lipoblasts were seen.
Typical staghorn pattern with proliferating lesional cells (H&E stain, x200)
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F4
The intervascular spaces were occupied by monomorphous plump spindle cells which had round to oval nuclei with scant to moderate cytoplasm, the cell borders were indistinct [Figure 4].
Reticulin stain showed distinctive reticulin pattern and each pericyte is surrounded by reticulin fibers (Reticulin stain, x100)
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F5
Immunohistochemical staining demonstrated that the neoplastic cells were strongly positive for reticulin [Figure 5] and negative for CD 99 [Figure 6], Bcl-2 [Figure 7], S-100 [Figure 8], Pancytokeratin [Figure 9], Desmin [Figure 10], CD34 [Figure 11] and smooth muscle actin (SMA) [Figure 12].
Immunohistochemistry revealing CD99 negativity (IHC stain, x100)
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F6
Immunohistochemical staining demonstrated that the neoplastic cells were strongly positive for reticulin [Figure 5] and negative for CD 99 [Figure 6], Bcl-2 [Figure 7], S-100 [Figure 8], Pancytokeratin [Figure 9], Desmin [Figure 10], CD34 [Figure 11] and smooth muscle actin (SMA) [Figure 12].
Immunohistochemistry revealing Bcl-2 negativity (IHC stain, x100)
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F7
Immunohistochemical staining demonstrated that the neoplastic cells were strongly positive for reticulin [Figure 5] and negative for CD 99 [Figure 6], Bcl-2 [Figure 7], S-100 [Figure 8], Pancytokeratin [Figure 9], Desmin [Figure 10], CD34 [Figure 11] and smooth muscle actin (SMA) [Figure 12].
Immunohistochemistry revealing S-100 negativity with positivity in fat containing cells (IHC stain, x100)
JOMFP-19-92-g008.jpg
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F8
Immunohistochemical staining demonstrated that the neoplastic cells were strongly positive for reticulin [Figure 5] and negative for CD 99 [Figure 6], Bcl-2 [Figure 7], S-100 [Figure 8], Pancytokeratin [Figure 9], Desmin [Figure 10], CD34 [Figure 11] and smooth muscle actin (SMA) [Figure 12].
Immunohistochemistry revealing Pan cytokeratin negativity (IHC stain, x100)
JOMFP-19-92-g009.jpg
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F9
Immunohistochemical staining demonstrated that the neoplastic cells were strongly positive for reticulin [Figure 5] and negative for CD 99 [Figure 6], Bcl-2 [Figure 7], S-100 [Figure 8], Pancytokeratin [Figure 9], Desmin [Figure 10], CD34 [Figure 11] and smooth muscle actin (SMA) [Figure 12].
Immunohistochemistry revealing Desmin negativity (IHC stain, x100)
JOMFP-19-92-g010.jpg
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F10
Immunohistochemical staining demonstrated that the neoplastic cells were strongly positive for reticulin [Figure 5] and negative for CD 99 [Figure 6], Bcl-2 [Figure 7], S-100 [Figure 8], Pancytokeratin [Figure 9], Desmin [Figure 10], CD34 [Figure 11] and smooth muscle actin (SMA) [Figure 12].
Immunohistochemistry revealing CD34 negativity in lesional cells, positivity in endothelial cells of vessels (IHC stain, x100)
JOMFP-19-92-g011.jpg
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F11
Immunohistochemical staining demonstrated that the neoplastic cells were strongly positive for reticulin [Figure 5] and negative for CD 99 [Figure 6], Bcl-2 [Figure 7], S-100 [Figure 8], Pancytokeratin [Figure 9], Desmin [Figure 10], CD34 [Figure 11] and smooth muscle actin (SMA) [Figure 12].
Immunohistochemistry revealing Smooth muscle actin negativity in lesional cells and positivity in vessel walls (arrow), (IHC stain, x100)
JOMFP-19-92-g012.jpg
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F12
Immunohistochemical staining demonstrated that the neoplastic cells were strongly positive for reticulin [Figure 5] and negative for CD 99 [Figure 6], Bcl-2 [Figure 7], S-100 [Figure 8], Pancytokeratin [Figure 9], Desmin [Figure 10], CD34 [Figure 11] and smooth muscle actin (SMA) [Figure 12].