Intradermal spindle cell/pleomorphic lipoma - A distinct subset
Intradermal spindle cell/pleomorphic lipoma - A distinct subset
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DOI：
10.1097/00000372-200012000-00003
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发表时间：
2000-12-01
影响因子：
1.1
通讯作者：
Fletcher, CDM
中科院分区：
文献类型：
--
作者：
French, CA;Mentzel, T;Fletcher, CDM
梭形细胞/多形性脂肪瘤是一组由原始梭形细胞、多核巨细胞和成熟脂肪细胞组成的良性脂肪生成性肿瘤。这些肿瘤很少被报道发生在真皮，在这个位置可能会被误诊。作者对157例梭形细胞/多形性脂肪瘤中的20例（12.7%）皮内病变进行了临床病理和免疫组化研究。患者年龄范围为20至85岁（中位数：42岁）; 20名患者中有14名为女性（70%）。解剖部位为头颈部（7例，其中4例发生在面部）、肩部/上背部（4例）、下肢（4例）、躯干（3例）和上肢（2例）。大多数病变表现为软而缓慢增大的皮肤结节，通常小于2.5 cm。组织学上，这些真皮病变不同于常见的梭形细胞/多形性脂肪瘤，无包膜，浸润边缘不清，尽管细胞形态学检查结果、粘稠的胶原蛋白和肥大细胞与常见的皮下病变相同。6例表现为多形性脂肪瘤。免疫组化显示，病变细胞CD 34阳性，S-100蛋白阴性。1例术后21年局部复发。真皮梭形细胞/多形性脂肪瘤的特点是明显好发于女性，比皮下病变的解剖分布更广，并且缺乏界限。这些不寻常的特征可能会导致鉴别诊断的问题。
Spindle cell/pleomorphic lipomas are a group of benign lipogenic tumors composed of primitive spindle cells, multinucleated giant cells, and mature adipocytes. These tumors have rarely been reported to arise in the dermis and may be misdiagnosed in this location. Twenty (12.7%) intradermal lesions identified among 157 spindle cell/pleomorphic lipomas in the authors' files were studied clinicopathologically and immunohistochemically. The patients' ages ranged from 20 to 85 years (median: 42 years); 14 of 20 patients were female (70%). Anatomical sites were the head/neck region (7 cases, 4 of which arose on the face), shoulder/upper back (4 cases), lower limbs (4 cases), trunk (3 cases), and upper limbs (2 cases). Most lesions presented as a soft and slowly enlarging cutaneous nodule, usually measuring less than 2.5 cm. Histologically, these dermal lesions differed from usual spindle cell/pleomorphic lipoma, being unencapsulated with poorly defined infiltrative margins, although the cytomorphologic findings, ropy collagen, and mast cells were as seen in usual subcutaneous lesions. Six cases showed features of pleomorphic lipoma. Immunohistochemically, lesional cells stained positively for CD34 and were negative for S-100 protein. One case recurred locally after 21 years. Dermal spindle cell/pleomorphic lipomas are distinctive in their apparent female predilection, wider anatomical distribution than subcutaneous lesions, and lack of circumscription. These unusual features can cause problems in differential diagnosis.