Abstract
We report a case of primary sarcoma of the skin with a biphasic histological pattern, being composed of areas of mixed mesenchymal-epithelial cell proliferation and areas of purely sarcomatous growth. The tumor occurred in the posterior cervical region of a 93-year-old man, and its history was marked by sudden, rapid enlargement after many years of stable duration. The excised lesion was about 4 cm in diameter, had a firm consistency and was covered by intact skin. Histological examination showed a multifocal proliferation of follicular germinative cells arranged in corymbiform and petaloid shapes with an overall retiform growth pattern. Epithelial cords and strands were composed of cytologically uniform cells with bland nuclear features and were surrounded by a prominent, fibroblast-rich stroma reminiscent of a perifollicular sheath. In many areas of the tumor the stroma showed abrupt transition into a pleomorphic proliferation of large sarcomatous cells with frequent and often atypical mitoses. Multinucleated neoplastic cells infiltrated the epithelial structures to cause their partial or total obliteration in many fields of the lesion. Immunohistochemically, the epithelial cells displayed expression of various keratins, with a particularly intense staining for 34βE12, and were partly positive for the CD10 antigen. A strong immunostaining for this antigen was also observed in malignant-appearing stromal areas, where no expression of cytokeratins was detected. Moreover, nuclear positivity for p53 protein was seen in sarcomatous cells, whereas it resulted in total lack of epithelial elements. Our case emphasizes that high-grade sarcoma may occur in the spectrum of trichoblastic tumors and that it may share some features of other noncutaneous biphasic neoplasms, such as mammary cystosarcoma phyllodes.
| Original language | English |
|---|---|
| Pages (from-to) | 79-83 |
| Number of pages | 5 |
| Journal | American Journal of Dermatopathology |
| Volume | 29 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Feb 2007 |
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Keywords
- Adnexal neoplasm of skin
- Carcinosarcoma
- CD10
- Cutaneous sarcoma
- Follicular papilla
- p53
- Trichoblastoma
ASJC Scopus subject areas
- Pathology and Forensic Medicine
- Dermatology
Cite this
Trichoblastic sarcoma : A high-grade stromal tumor arising in trichoblastoma. / Rosso, Renato; Lucioni, Marco; Savio, Tommaso; Borroni, Giovanni.
In: American Journal of Dermatopathology, Vol. 29, No. 1, 02.2007, p. 79-83.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Trichoblastic sarcoma
T2 - A high-grade stromal tumor arising in trichoblastoma
AU - Rosso, Renato
AU - Lucioni, Marco
AU - Savio, Tommaso
AU - Borroni, Giovanni
PY - 2007/2
Y1 - 2007/2
N2 - We report a case of primary sarcoma of the skin with a biphasic histological pattern, being composed of areas of mixed mesenchymal-epithelial cell proliferation and areas of purely sarcomatous growth. The tumor occurred in the posterior cervical region of a 93-year-old man, and its history was marked by sudden, rapid enlargement after many years of stable duration. The excised lesion was about 4 cm in diameter, had a firm consistency and was covered by intact skin. Histological examination showed a multifocal proliferation of follicular germinative cells arranged in corymbiform and petaloid shapes with an overall retiform growth pattern. Epithelial cords and strands were composed of cytologically uniform cells with bland nuclear features and were surrounded by a prominent, fibroblast-rich stroma reminiscent of a perifollicular sheath. In many areas of the tumor the stroma showed abrupt transition into a pleomorphic proliferation of large sarcomatous cells with frequent and often atypical mitoses. Multinucleated neoplastic cells infiltrated the epithelial structures to cause their partial or total obliteration in many fields of the lesion. Immunohistochemically, the epithelial cells displayed expression of various keratins, with a particularly intense staining for 34βE12, and were partly positive for the CD10 antigen. A strong immunostaining for this antigen was also observed in malignant-appearing stromal areas, where no expression of cytokeratins was detected. Moreover, nuclear positivity for p53 protein was seen in sarcomatous cells, whereas it resulted in total lack of epithelial elements. Our case emphasizes that high-grade sarcoma may occur in the spectrum of trichoblastic tumors and that it may share some features of other noncutaneous biphasic neoplasms, such as mammary cystosarcoma phyllodes.
AB - We report a case of primary sarcoma of the skin with a biphasic histological pattern, being composed of areas of mixed mesenchymal-epithelial cell proliferation and areas of purely sarcomatous growth. The tumor occurred in the posterior cervical region of a 93-year-old man, and its history was marked by sudden, rapid enlargement after many years of stable duration. The excised lesion was about 4 cm in diameter, had a firm consistency and was covered by intact skin. Histological examination showed a multifocal proliferation of follicular germinative cells arranged in corymbiform and petaloid shapes with an overall retiform growth pattern. Epithelial cords and strands were composed of cytologically uniform cells with bland nuclear features and were surrounded by a prominent, fibroblast-rich stroma reminiscent of a perifollicular sheath. In many areas of the tumor the stroma showed abrupt transition into a pleomorphic proliferation of large sarcomatous cells with frequent and often atypical mitoses. Multinucleated neoplastic cells infiltrated the epithelial structures to cause their partial or total obliteration in many fields of the lesion. Immunohistochemically, the epithelial cells displayed expression of various keratins, with a particularly intense staining for 34βE12, and were partly positive for the CD10 antigen. A strong immunostaining for this antigen was also observed in malignant-appearing stromal areas, where no expression of cytokeratins was detected. Moreover, nuclear positivity for p53 protein was seen in sarcomatous cells, whereas it resulted in total lack of epithelial elements. Our case emphasizes that high-grade sarcoma may occur in the spectrum of trichoblastic tumors and that it may share some features of other noncutaneous biphasic neoplasms, such as mammary cystosarcoma phyllodes.
KW - Adnexal neoplasm of skin
KW - Carcinosarcoma
KW - CD10
KW - Cutaneous sarcoma
KW - Follicular papilla
KW - p53
KW - Trichoblastoma
UR - http://www.scopus.com/inward/record.url?scp=33846867440&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33846867440&partnerID=8YFLogxK
U2 - 10.1097/01.dad.0000208268.89861.38
DO - 10.1097/01.dad.0000208268.89861.38
M3 - Article
C2 - 17284968
AN - SCOPUS:33846867440
VL - 29
SP - 79
EP - 83
JO - American Journal of Dermatopathology
JF - American Journal of Dermatopathology
SN - 0193-1091
IS - 1
ER -