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Atypical
fibroxanthoma of the external ear in a cardiac transplant recipient:
Case report and the causal role of the immunosuppressive
therapy.Auris Nasus Larynx.2007 Sep 4;
Atypical
fibroxanthoma (AF) is an unusual cutaneous fibrohistiocytic tumour
that is most commonly found in ENT sun-exposed areas of elderly
males. Cardiac transplant patients have an increased incidence of
multiple cutaneous neoplasms, but the AF is uncommon. Although this
neoplasm is benign, it may mimic spindle cell carcinoma, squamous
cell carcinoma, melanoma and soft tissue sarcoma on histologic
examination. Immunohistochemical stains for cytokeratin,
alpha-1-antichymotrypsin, S100 protein and vimentin may be helpful
in differential diagnosis. AF rarely recur or metastasize, if wide
excision has been performed. We present a case of a cardiac
transplant recipient who developed, after multiple cutaneous
squamous tumours, an AF of external ear following the prolonged
immunosuppressive treatment with cyclosporin.
Clear cell
atypical fibroxanthoma - report of a case with review of the
literature. J Cutan Pathol.2006 May;33(5):343-8.
Clear cell
atypical fibroxanthoma (CCAFX) is a rare variant of atypical
fibroxanthoma (AFX), a pleomorphic dermal tumour associated with a
good prognosis. A 67-year-old man presented with a rapidly growing
nodule on the ear, which had appeared over a 2-week period. Sections
showed an ulcerated nodule composed of pleomorphic spindled and
polygonal cells with clear cytoplasm, invested by a delicate
vascular stroma, reminiscent of clear cell renal cell carcinoma.
Numerous mitotic figures were seen. The tumour cells stained with
vimentin, CD68 and CD99 and were cytokeratin-negative. The
immunohistochemical and ultrastructural features supported a
diagnosis of CCAFX. The diagnosis of CCAFX requires the exclusion of
other pleomorphic clear cell tumours that can occur in the skin by
using a combination of morphology, immunohistochemistry and
electronmicroscopy. Murali R, Palfreeman S. Clear cell atypical
fibroxanthoma - report of a case with review of the literature.
Fibroxanthoma of
the external auditory canal. Acta Otorrhinolaringol Esp.2005
May;56(5):219-21.
Atypical
fibroxanthoma is an scarce skin tumor which usually develops in
exposed areas of elderly persons. It is very uncommon in the
external auditory canal, where it might be wrongly diagnosed as a
sebaceous cyst or carcinoma. We report a case of atypical
fibroxanthoma of the external auditory canal and review the current
procedure for the differential diagnosis of these lesions.
Granular
Cell Variant of Atypical Fibroxanthoma.Pathol. Oncol Res.1996;2(4):244-247.
We report a
case of atypical fibroxanthoma of the ear in which the dominant part
of the tumor has granular cell appearance. Areas identical to
conventional atypical fibroxanthoma were present only at the lateral
infiltrating borders. Histologically the granular cells resembled
those of the classical granular cell tumors but exhibited
significant pleomorphism and a high mitotic rate. Immunostains for
vimentin, CD68 and NK1/C3 were positive but for S-100, HMB-45,
myogenic and epithelial markers were negative. The predominance of
the granular cells in an atypical fibroxanthoma supports the concept
that a small subset of tumors with granular cell phenotype are of
nonneural origin.
Ultrastructure of
spindle cell squamous carcinoma.J Cutan Pathol. 1976;3(1):17-24.
A
63-year-old white male presented with a nine-month history of a
nontender ulcerated lesion on his ear. Light microscopy demonstrated
a moderately well circumscribed lesion in the dermis which abutted
upon epidermis. There was no evidence of continuity between the
tumor and overlying epithelium. The tumor was very cellular with an
admixture of cells - spindle, polyhedral and bizarre giant cells.
Mitotoc figures were abundant and frequently abnormal. We
interpreted this lesion to have the clinical and pathologic features
of an atypical fibroxanthoma (AFX). Ultrastructure, however, showed
abundant tonofilaments and desmosomes indicative of an epithelial
origin and therefore most consistent with a spindle cell squamous
carcinoma (SCSC). It is urged that, when possible, electron
microscopy be performed on problematic cases diagnosed either as an
AFX or spindle cell squamous carcinoma since it is the most valid
basis on which a correct diagnosis can be made.
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