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Clear‐cell atypical fibroxanthoma: an uncommon histopathologic variant of atypical fibroxanthoma
Author(s) -
Requena Luis,
Sangueza Omar P.,
Yus Evaristo Sánchez,
Furio Vicente
Publication year - 1997
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.1600-0560.1997.tb01573.x
Subject(s) - atypical fibroxanthoma , pathology , cytokeratin , multinucleate , giant cell , biology , vimentin , immunohistochemistry , medicine
Atypical fibroxanthoma is a superficial variant of pleomorphic malignant fibrous histiocytoma. Histopathologically, it is characterized by a dermal nodule composed of bizarre cells arranged in a haphazard‐to‐fascicular pattern. These cells are spindle or rounded, pleomorphic and with numerous atypical mitotic figures. Some cells appear polygonal with ample and foamy cytoplasm. We recently encountered two elderly patients with atypical fibroxanthoma on their face. Histopathologically, one of the lesions was composed, almost entirely, of clear cells, whereas in the other one aggregations of clear cells constituted a half of the neoplasm. Atypical multinucleated cells with a Touton‐like appearance were present. In addition to clear cells, areas of more conventional atypical spindle cells arranged in fascicles were seen, supporting the diagnosis of atypical fibroxanthoma. PAS staining failed to demonstrate glycogen in neoplastic cells. Immunohistochemistry revealed that neoplastic cells expressed positivity for vimentin, muscle‐specific actin, and alpha smooth muscle actin, whereas cytokeratin, S‐100 protein, EMA, CEA, and clesmin were negative. Ultrastructural studies showed that neoplastic cells contained abundant rough endoplasmic reticulum, mitochondria, and numerous lipid vacuoles within the cytoplasm. Clear‐cell atypical fibroxanthoma is a rare variant of atypical fibroxanthoma that should be differentiated from other clear‐cell neoplasms of the skin.