PMC3420401_01
Clinical presentation.
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fig1
A 31-year-old man presented with an asymptomatic, slowly enlarging, exophytic, brownish nodule of the abdominal wall with surface telangectasia (Figure 1).
Cellular dermal proliferation of spindle and pleomorphic cells with epidermal hyperplasia, a grenz zone, and prominent blood-filled spaces (hematoxylin and eosin x40).
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fig2
Histological findings demonstrated a well-defined unencapsulated dermal nodule with epidermal hyperplasia, an interposed grenz zone (defined as relatively normal collagen forming a boundary between normal epidermis and a dermal lesion) (Figure 2) and superficial involvement of the subcutis.
Histiocyte-like and fibroblast-like spindle cells intermingled with atypical mononuclear and giant cells, sometimes with foamy cytoplasm, showing nuclear pleomorphism and bizarre nuclei; a mitosis is seen in the upper right (hematoxylin and eosin x100).
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fig3
These cells were intermingled with atypical mononuclear and giant cells, sometimes with foamy cytoplasm, showing large, hyperchromatic, irregular nuclei; we found 4 mitotic figures per ten high-power fields (Figure 3).
Tumor cells are focally positive for CD68 (immunohistochemistry x400).
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fig4
Immunohistochemical stains showed focal immunoreactivity for CD68 (Figure 4), while cells were completely negative for S100 protein, HMB45, CD34 and alpha smooth muscle actin.