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Pleomorphic spindle cell dermal neoplasm with dot‐like keratin reactivity: keratin‐positive AFX or carcinoma?
Author(s) -
Ellis Ransom,
Chase Elizabeth,
Barland Alycia,
Rajpara Anand,
Fraga Garth R.
Publication year - 2015
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.12548
Subject(s) - atypical fibroxanthoma , keratin , pathology , immunolabeling , immunohistochemistry , neoplasm , keratin 8 , medicine , biology
Atypical fibroxanthoma (AFX) is an uncommon cutaneous neoplasm of pleomorphic myofibroblast‐like cells. Diagnosis requires exclusion of other undifferentiated spindle and pleomorphic cell neoplasms by immunohistochemistry. We report two patients with p63‐non‐reactive spindle cell neoplasms which resembled AFX but demonstrated anomalous dot‐like immunolabeling with antibodies to high molecular weight keratin and keratin 5. One case recurred locally, suggesting such lesions may behave aggressively. Whether these lesions represent keratin‐positive dermal sarcomas or poorly differentiated carcinomas is debatable. Regardless of exact classification, our experience suggests such cases should be managed as high‐risk non‐melanoma skin cancers.