Dermal and Subcutaneous Tumors – Part II. Michael Hohnadel March 2004. Kaposi’s Sarcoma. Five Presentations: 1. Classic Middle aged, European men Red, violaceous nodules on toes or soles. Coalesce to form plaques. Brawny edema
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Dermal and Subcutaneous Tumors – Part II
2. African Cutaneous
3. African Lymphadenopathic
5. Lymphoma / immunosuppressive TX.
Resembles classic but more variable presentation.
Early lesion with dilated thin walled vascular vessels with protruding endothelial cells.
Later, ‘hemangioma- like’ lesion.
Spindle cell Hemangioendothelioma
4 Clinical settings:
1.) Head and neck tumor of elderly
2.) In area of chronic lyphedema.
3.) Previously irradiated sites
4.) Miscellaneous subset.
Infiltration of the dermis by ill-defined vascular spaces and hyperchromatic, atypical endothelial cells. Factor VIII staining is positive.
Hypertrophic Scar at 5 months and 1 year
As Dr. Ladd would say: ‘Something just ain’t right…..’
Congenital Generalized Fibromatosis
Infantile Digital Fibromatosis
Whorled fascicles of spindle cells
Eosinophilic inclusion bodies
Sheets of epithelioid histiocytes with a
variable number of the characteristic
multinucleated osteoclast-like giant cells. Some of the histiocytes may have pale foamy cytoplasm.
Fibrous and vascular proliferation of upper dermis
Fibrous papule of the nose
Pearly Penile Papule
Nodular proliferation of spindled fibroblasts and histiocytes in the reticular dermis, with hyperplasia and hyperpigmentation of the overlying epidermis. There is extension into the subcutaneous tissue in a radial pattern (arrow).
The fibroblasts are arranged in broad intersecting fascicles with entrapment of thick collagen bundles
Characteristic multilayered pattern of infiltration into the subcutaneous tissue
Spindle-shaped cells are arranged in a ‘storiform’ pattern.
Spindle-shaped and stellate fibroblasts are loosely arranged in a myxomatous stroma, with some cells in mitosis
Epithelioid cells are palisaded around an area of necrosis.
1.) Digital Mucous cyst.
2.) Cutaneous Myxomas