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Cellular digital fibromas: distinctive CD34‐positive lesions that may mimic dermatofibrosarcoma protuberans
Author(s) -
McNiff Jennifer M.,
Subtil Antonio,
Cowper Shawn E.,
Lazova Rossitza,
Glusac Earl J.
Publication year - 2005
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/j.0303-6987.2005.00358.x
Subject(s) - dermatofibrosarcoma protuberans , cd34 , pathology , factor xiiia , stromal cell , fibroma , reticular connective tissue , staining , immunohistochemistry , s100 protein , dermis , dermatopathology , medicine , biology , stem cell , microbiology and biotechnology
Background: Digital fibromas are common benign acral tumors typically reported as angiofibromas (AFs) or acquired digital fibrokeratomas (ADFs). Cellular variants are not well recognized. Methods: We collected 14 acral fibrocytic lesions showing a spindle cell morphology from our files, and evaluated CD34, Factor XIIIa, epithelial membrane antigen (EMA), and S100 protein staining of these lesions. We compared the histologic and immunohistochemical features of these cellular fibromas with five digital AFs, five ADFs, and five digital dermatofibromas. Results: The 14 cellular digital fibromas showed intersecting fascicles of thin delicate bland spindle cells in the superficial reticular dermis with a fibrotic‐to‐slight myxoid stroma. The spindle cells in all cases stained strongly for CD34, and only scattered stromal cells stained for Factor XIIIa. Five tested cases were negative for EMA and S100 protein. The digital AFs, fibrokeratomas, and dermatofibromas stained predominately for Factor XIIIa, with no or minimal staining for CD34. Conclusions: These findings suggest that a subset of digital fibromas is characterized by a dense cellular proliferation of CD34‐positive spindle cells. Awareness of this variant of digital fibroma and its staining pattern is critical in preventing misdiagnosis as dermatofibrosarcoma protuberans, particularly in superficial biopsies.