误诊为血管瘤的早期隆突性皮肤纤维肉瘤1例

A Case of Early Stage Dermatofibrosarcoma Protuberans Misdiagnosed as Hemangioma

患者男,39岁,胸部皮疹1年余,渐增大。皮肤科情况:右侧胸部一约2 cm×0.5 cm大小青色至红色皮下结节,表面光滑,触之质地稍软,压痛阴性。B超检查提示血管瘤可能性大。皮损组织病理示:梭形细胞肿瘤,累及真皮中下部。免疫组织化学染色示:CD34(+),FⅩⅢA(灶性+),CD163(灶性+),Ki67(3%~5%+),p53(野生型),SMA(-),S100(-),Desmin(-),β-Catenin(-),D2-40(-)。荧光原位杂交检测:COL1A1/PDGFβ(+)。诊断:隆突性皮肤纤维肉瘤。

A 39-year-old male presented with a skin lesion on the chest more than 1 year.Physical examination revealed a painless blue-red subcutaneous nodular with a smooth surface on the right chest measuring 2 cm×0.5 cm.The hardness of the lesion was soft.The Ultrasound B showed the lesion be likely to hemangioma.Histopathology of the lesion showed massive spindle cells were found in the middle and lower part of dermis.Immunohistochemical staining showed CD34,FⅩⅢA focal,CD163 focal,Ki67(3%-5%+)and p53(wild type)were positive,while SMA,S100,Desmin,β-Catenin and D2-40 were negative.COL1A1/PDGFβ was detected by fluorescence in-situ hybridization(FISH) analysis in the lesion.The diagnosis of dermatofibrosarcoma protuberans was made.