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Fibrohistiocytic neoplasms

Fibrohistiocytic neoplasms. Carlos A. Cerruto, MD. Acral Fibrokeratoma Clinical Features. May be Hx of trauma Solitary dome-shaped horn Found in 50% patients with tuberous sclerosis (subungual and periungual fibroma) May originate from dermis or prox nail fold.

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Fibrohistiocytic neoplasms

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  1. Fibrohistiocytic neoplasms Carlos A. Cerruto, MD

  2. Acral FibrokeratomaClinical Features • May be Hx of trauma • Solitary dome-shaped horn • Found in 50% patients with tuberous sclerosis (subungual and periungual fibroma) • May originate from dermis or prox nail fold

  3. Acral FibrokeratomaHistologic Features • Central dermal fibrovascular core • Vertically oriented dermal collagen • Irregular epidermal hyperplasia • Thickened stratum corneum

  4. Angiofibroma

  5. Fibrous Papule

  6. Angiofibroma - Histology • Dome shaped papule • Ectatic vessels • Bizarre dermal fibroblastic cells • Mild basilar hyperpigmentation • Granular and clear cell variants

  7. CASE # 5 • 40 y.o. female with polypoid lesion on her arm. Your diagnosis is: • A) Acrochordon • B) Atypical fibroxanthoma • C) Pleomorphic dermatofibroma • D) Pleomorphic fibroma • E) Dermatofibroma with monster cells

  8. A) Acrochordon B) Atypical fibroxanthoma C) Pleomorphic dermatofibroma D) Pleomorphic fibroma E) Dermatofibroma with monster cells

  9. CASE # 4 • All associations of this lesion are false, EXCEPT: • A) Multiple lesion are seen in Bannayan-Zonana syndrome • B) Multiple lesion are seen in Bloch-Sulzberger syndrome • C) Multiple lesions are seen in Cowden’s disease • D) Multiple lesions are seen in Birt-Hogg-Dube syndrome • E) Multiple lesions are seen in NF type I

  10. CASE # 4 • All associations of this lesion are false, EXCEPT: • A) Multiple lesion are seen in Bannayan-Zonana syndrome • B) Multiple lesion are seen in Bloch-Sulzberger syndrome • C) Multiple lesions are seen in Cowden’s disease • D) Multiple lesions are seen in Birt-Hogg-Dube syndrome • E) Multiple lesions are seen in NF type I

  11. Sclerotic Fibroma - Histology • Well circumscribed , unencapsulated dermal nodule • Paucicellular • Thickened homogenized eosinophilic bland spindled cells • Laminated pattern with clefting • Whorled wood grain pattern

  12. CASE # 1 • 45 y.o. male with a recent growing nodule. Your diagnosis is: • A) Malignant fibrous histiocytoma • B) Deep fungal infection • C) Nodular fasciitis • D) Fibrous sarcoma • E) Leiomyoma

  13. A) Malignant fibrous histiocytoma B) Deep fungal infection C) Nodular fasciitis D) Fibrous sarcoma E) Leiomyoma

  14. Nodular Fasciitis – Circ. Border

  15. Nodular Fasciitis

  16. Nodular Fasciitis - Tissue Culture

  17. Nodular fascitis- Cystic change

  18. Fibrosarcoma - HP

  19. Fibrous Hamartoma of Infancy

  20. DF - Radial pattern at interface

  21. DF - Collagen trapping

  22. Fibrocollagenous Storiform Cellular Histiocytoma Lipidized Angiomatous Aneurysmal Clear cell Granular cell Halo Monster cell Osteoclastic Myofibroblastic Myxoid Keloidal Palisading Atrophic Subcutaneous Combined DF variants

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