长期误诊的隆突性皮肤纤维肉瘤1例

Long-term misdiagnosis of dermatofibrosarcoma protuberans:A case report

患者女,61岁,腹部浸润性黯红色斑块20余年,增生1年。皮肤科查体:下腹部可见10 cm×5 cm大小的无痛性黯红色硬结样皮肤增厚,表面凹凸不平,左下方可见数个圆形、椭圆形表面光滑的增生性结节。增生性结节组织病理检查:梭形细胞肿瘤,瘤细胞呈束状或交织状排列,细胞有轻度异形性,核分裂像罕见。免疫组化染色结果:肿瘤细胞CD34(+),Ki-67(10%+)。最终诊断:隆突性皮肤纤维肉瘤。

A 61-year-old female patient presented with dark red infiltrating plaques on the lower abdomen for over 20 years,with hyperplasia for 1 year.Dermatological examination revealed a painless,indurated,dark red skin thickening measuring 10 cm x 5 cm on the lower abdomen,with an uneven surface.Several smooth,proliferative nodules of round and oval shape were noted on the lower left side of the skin lesion,Histopathological examination of the proliferative nodules showed spindle cell tumor,with tumor cells arranged in bundles or interwoven patterns,mild nuclear atypia,and rare mitotic figures.Immunohistochemical staining revealed tumor cells to be positive for CD34 and Ki-67(10%+).The diagnosis of dermatofibrosarcoma protuberans was made.