RESUMEN
Benign fibrous histiocytoma (BFH) within the intracerebral region is remarkably rare. Our report details 2 cases of unusual BFH instances that exhibit no adhesion to the dura mater or cerebral falx, accompanied by a comprehensive literature review. While magnetic resonance imaging demonstrates specific characteristics for BFH, it does not readily differentiate BFH from more common brain neoplasms like gliomas and metastatic tumors. The definitive diagnosis of BFH depends primarily on histopathological and immunohistochemical examinations. Total surgical resection is considered an efficacious therapeutic approach, emphasizing the necessity for prolonged postoperative surveillance to detect any potential tumor recurrence or metastasis.
Asunto(s)
Neoplasias Encefálicas , Histiocitoma Fibroso Benigno , Imagen por Resonancia Magnética , Humanos , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/patología , Histiocitoma Fibroso Benigno/patología , Histiocitoma Fibroso Benigno/diagnóstico por imagen , Histiocitoma Fibroso Benigno/cirugíaRESUMEN
BACKGROUND: Dermatofibroma (DF) is a common benign soft-tissue tumor. It occurs anywhere on the body but is commonly seen on the upper and lower extremities. It is frequently found in young to middle-aged adults and predominantly in females. METHODS: Thirty-one patients with DF on the foot and ankle diagnosed and treated during a 6-year period were characterized. RESULTS: The patients (16 males, 15 females) were aged 7 to 75 years (average, 55 years). Clinically, 17 patients noted painful symptoms, and 14 were painless. Grossly, DF manifested as a raised red, pink, tan, or skin-colored soft mass. The tumor size ranged from 0.3 to 1.5 cm (average, 0.67 cm in diameter). Twenty-six DFs (84%) were localized on the dorsal surface of the foot and ankle, and five (16%) were found on the plantar aspect. Eighteen patients were treated by surgical excision of the tumor (>0.5 cm), and 13 patients had observational follow-up after punch biopsy due to the small size (≤0.5 cm) and benign nature of these lesions. Further follow-up found that only one patient (3.2%) had a local recurrence, 37 months after surgical excision, which was completely reexcised. Histologically, DF is characterized by proliferation of spindle fibroblasts and histiocytes, in a vague fascicular pattern, and thickened collagen bundles. CONCLUSIONS: Dermatofibroma on the foot and ankle predominantly occurs in patients in their 50s, without a preponderance by sex. It needs to be differentiated from other benign and malignant tumors with histologic analysis and immunostaining with factor XIIIa, CD68, and other biomarkers. Treatment options include either surgical excision or observational follow-up after biopsy, depending on the clinical characteristics and effect on functional activity.
Asunto(s)
Tobillo , Histiocitoma Fibroso Benigno , Humanos , Femenino , Masculino , Persona de Mediana Edad , Histiocitoma Fibroso Benigno/patología , Histiocitoma Fibroso Benigno/cirugía , Adulto , Anciano , Adolescente , Niño , Adulto Joven , Tobillo/patología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Estudios Retrospectivos , Pie/patología , Estudios de SeguimientoAsunto(s)
Histiocitoma Fibroso Benigno , Neoplasias Cutáneas , Humanos , Masculino , Histiocitoma Fibroso Benigno/patología , Histiocitoma Fibroso Benigno/diagnóstico , Histiocitoma Fibroso Benigno/diagnóstico por imagen , Histiocitoma Fibroso Benigno/cirugía , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , Persona de Mediana EdadRESUMEN
RATIONALE: Sclerosing angiomatoid nodular transformation (SANT) of the spleen is an uncommon benign vascular lesion with an obscure etiology. It predominantly affects middle-aged women and presents with nonspecific clinical signs, making preoperative diagnosis challenging. The definitive diagnosis of SANT relies on pathological examination following splenectomy. This study aims to contribute to the understanding of SANT by presenting a case series and reviewing the literature to highlight the clinical presentation, diagnostic challenges, and treatment outcomes. PATIENT CONCERNS: In this retrospective study, we analyzed the clinical data of 3 patients with confirmed SANT admitted from November 2013 to October 2023. The cases include a 25-year-old male, a 15-year-old female, and a 39-year-old male, each with a splenic mass. DIAGNOSES AND INTERVENTIONS: All of the three cases were treated by laparoscopic splenectomy (LS). Pathological examination confirmed SANT in all cases. OUTCOMES: No recurrence or metastasis was observed during a 10-year follow-up for the first 2 cases, and the third case showed no abnormalities at 2 months postoperatively. Despite its rarity, SANT is a significant condition due to its potential for misdiagnosis and the importance of distinguishing it from malignant lesions. The study underscores the utility of LS as a safe and effective treatment option. LESSONS: SANT is a rare benign tumor of the spleen, and the preoperative diagnosis of whom is challenging. LS is a safe and effective treatment for SANT, with satisfactory surgical outcomes and favorable long-term prognosis on follow-up. The study contributes to the limited body of research on this rare condition and calls for larger studies to validate these findings and improve clinical management.
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Esplenectomía , Neoplasias del Bazo , Humanos , Masculino , Adulto , Femenino , Esplenectomía/métodos , Adolescente , Neoplasias del Bazo/patología , Neoplasias del Bazo/cirugía , Neoplasias del Bazo/diagnóstico , Bazo/patología , Histiocitoma Fibroso Benigno/patología , Histiocitoma Fibroso Benigno/cirugía , Histiocitoma Fibroso Benigno/diagnóstico , Estudios Retrospectivos , Laparoscopía/métodos , Diagnóstico Diferencial , Enfermedades del Bazo/cirugía , Enfermedades del Bazo/patología , Enfermedades del Bazo/diagnósticoRESUMEN
ABSTRACT: Sclerosing angiomatoid nodular transformation (SANT) is a reactive non-neoplastic, rare vascular lesion of the spleen. The histology shows multiple angiomatoid nodules surrounded by proliferative stroma. A 31-year-old lady presented with an abdominal mass for 6 months. Contrast-enhanced computed tomography (CECT) abdomen was suggestive of hemangiopericytoma/hemangioendothelioma. An open splenectomy was performed, and the resected specimen was sent for histopathology examination. The gross examination showed a bosselated mass present at the lower pole of the spleen measuring 8 × 8 cm with peripherally located coalescing red-brown nodules embedded in a dense fibrous stroma on the cut surface. On microscopy, multiple circumscribed angiomatoid nodules comprising irregular slit-like vascular channels lined by plump endothelial cells were seen embedded in dense sclerotic stroma. Because of the lack of specific diagnostic features, it is difficult to diagnose SANT clinically and radiologically. However, the typical histopathological findings are a clue in clinching the diagnosis.
Asunto(s)
Bazo , Esplenectomía , Tomografía Computarizada por Rayos X , Humanos , Adulto , Femenino , Bazo/patología , Bazo/diagnóstico por imagen , Neoplasias del Bazo/patología , Neoplasias del Bazo/cirugía , Neoplasias del Bazo/diagnóstico , Neoplasias del Bazo/diagnóstico por imagen , Histocitoquímica , Microscopía , Histiocitoma Fibroso Benigno/patología , Histiocitoma Fibroso Benigno/diagnóstico , Histiocitoma Fibroso Benigno/cirugía , Histiocitoma Fibroso Benigno/diagnóstico por imagen , Radiografía Abdominal , Hemangiopericitoma/patología , Hemangiopericitoma/diagnóstico , Hemangiopericitoma/diagnóstico por imagen , Hemangiopericitoma/cirugíaRESUMEN
This article represents the first reported case in the external auditory canal of epithelioid fibrous histiocytoma (EFH), a rare benign cutaneous epithelioid neoplasm. Immunostaining revealed uncommon negative staining for anaplastic lymphoma kinase (ALK) expression. This case and literature review outline the diagnostic strategy for this highly unusual neoplasm. Laryngoscope, 134:3371-3373, 2024.
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Quinasa de Linfoma Anaplásico , Conducto Auditivo Externo , Neoplasias del Oído , Histiocitoma Fibroso Benigno , Humanos , Quinasa de Linfoma Anaplásico/genética , Quinasa de Linfoma Anaplásico/metabolismo , Conducto Auditivo Externo/patología , Neoplasias del Oído/patología , Neoplasias del Oído/cirugía , Neoplasias del Oído/diagnóstico , Histiocitoma Fibroso Benigno/patología , Histiocitoma Fibroso Benigno/diagnóstico , Histiocitoma Fibroso Benigno/cirugíaRESUMEN
Introduction: The objective of this study was to describe the CT and MRI features of sclerosing angiomatoid nodular transformation (SANT) of the spleen with pathologic correlation. Materials and Methods: Ten patients with surgically resected and pathologically confirmed SANTs were included. Clinical history was reviewed, and gross pathologic, histologic, and immunohistochemical findings were recorded. CT and MRI examinations were evaluated by two radiologists. Results: Patients included seven men and three women, with a mean age of 42.9±16.7 years. Pathologic features of SANTs involved multiple angiomatous nodules in a radiating pattern with a central stellate fibrous scar and evidence of hemosiderin deposition. 9 cases showed a lobulated demarcated margin, 8 cases a slight hypoattenuating, 1 isoattenuating, and 1 case with two lesions demonstrated a slight hyperattenuating margin, respectively. Multiple scattered punctate calcifications were involved in 2 cases. 5 cases manifested hypointensity on in-phase imaging, 1 iso-intensity, and 4 iso-hypointensity on out-of-phase imaging. Progressive and centripetal enhancement were exhibited in 10 cases, spoke-wheel pattern in 3 cases, and nodular enhancement in 4 cases, respectively. The central fibrous scar was identified in 8 cases during delayed enhancement. Conclusion: Characteristics of SANTs on CT/MRI reflected the underlying pathology. Hypointensity on DWI and T2WI, and change of signal on T1 chemicalshift imaging were found to be due to hemosiderin deposition and fibrous tissue. Typical feature was a solitary, round, lobulated mass with a fibrous scar. Progressive and centripetal enhancement, spoke-wheel pattern, nodular enhancement, and delayed enhancement of central fibrous scar were observed.
Asunto(s)
Histiocitoma Fibroso Benigno , Bazo , Masculino , Humanos , Femenino , Adulto , Persona de Mediana Edad , Bazo/diagnóstico por imagen , Bazo/patología , Histiocitoma Fibroso Benigno/diagnóstico por imagen , Histiocitoma Fibroso Benigno/cirugía , Histiocitoma Fibroso Benigno/patología , Cicatriz/patología , Hemosiderina , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: The purpose of this study was to evaluate the CT and MRI findings, clinicopathologic features, and differential diagnosis of Sclerosing angiomatoid nodular transformation (SANT). METHODS AND MATERIALS: Seven men and seven women with pathological diagnoses of SANT were included in this retrospect study. Patients underwent at least one radiological examination before surgery. The number, shape, margin, size, attenuation, signal intensity, homogeneity, and enhancing pattern of the lesion were evaluated by two abdominal radiologists independently. Immunohistochemistry reports were available for 11 patients. The immunoreactivity to the vascular markers CD8, CD31, and CD34 was assessed. RESULTS: The 14 SANT patients (7 men, 7 women; mean age, 43.5 years; age range, 24-56 years) presented with a single lesion and showed no specific clinical symptoms. Among 14 patients, 12 patients underwent MR scan, 5 patients underwent CT scan and 3 patients underwent PET-CT. On CT, all 5 lesions showed hypodensity on non-contrast images and spoke-wheel enhancing pattern after contrast administration, and calcification was observed. On T2WI, 10 cases(83.3%)showed hypointensity and 2 cases (16.7%) showed hyperintensity with central hypointensity. On T1WI, 10 cases (83.3%) were isointense and 2 cases (16.7%) were slightly hypointense. 10 cases (83.3%) showed hypointensity on DWI and 2 cases (16.7%) showed slightly hyperintensity on DWI. After contrast administration, all 12 lesions showed progressive enhancement. 18 F-fluorodeoxyglucose (FDG) uptake in the tumor was seen in all three cases that underwent PET-CT. The maximum standardized uptake value (SUVmax) was 4.5, 5.1, and 3.8 respectively. RESULTS: Apart from the progressive spoke-wheel enhancing pattern, DWI and ADC findings will add value to the diagnosis of SANT.
Asunto(s)
Histiocitoma Fibroso Benigno , Bazo , Masculino , Humanos , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Tomografía Computarizada por Tomografía de Emisión de Positrones , Histiocitoma Fibroso Benigno/diagnóstico por imagen , Histiocitoma Fibroso Benigno/cirugía , Tomografía Computarizada por Rayos X , AbdomenRESUMEN
BACKGROUND: Multinucleate cell angiohistiocytoma (MCAH) is an unusual fibrohistiocytic proliferation in the dermis with vascular hyperplasia. Numerous clinicopathological studies of MCAH have been published, but little has been written in relation to treatment. OBJECTIVES: The aim of the present study is to review the therapeutical approaches for MCAH in the literature and to report the results of the different therapies followed at our institution. METHODS: A literature review was conducted including all MCAH published cases that followed any therapy. Search terms included "multinucleate cell angiohistiocytoma" or "MCAH" and "treatment" or "therapy". Also, all cases of MCAH treated at our institution from 2010 to 2020 are reported. RESULTS: The literature search revealed 16 cases of MCAH treated with any of the therapeutic options. At our institution, 9 patients have been treated of MCAH between 2010 and 2020. Over 75% of them were female, and the median age was 56 years (range 47-73). More than 50% had lesions on the dorsum of the hands. Surgical excision was indicated in 2 patients, ablative CO2 laser was used in 1 patient and the 6 remaining ones followed vascular-targeted therapies (PDL and IPL). A satisfactory cosmetic result was achieved in all of them. CONCLUSIONS: We propose PDL therapy as a first-line treatment for MCAH since it achieves satisfactory esthetic results, while being well-tolerated. Selecting those amenable patients according to morphologic characteristics may be useful to avoid unsuccessful therapies. In MCAH with predominant fibrous stroma, surgery or CO2 laser may be the best option.
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Histiocitoma Fibroso Benigno , Neoplasias Cutáneas , Humanos , Femenino , Persona de Mediana Edad , Anciano , Masculino , Histiocitoma Fibroso Benigno/cirugía , Histiocitoma Fibroso Benigno/patología , Neoplasias Cutáneas/terapia , Neoplasias Cutáneas/patología , Células Gigantes/patología , Hiperplasia/patología , EstéticaRESUMEN
We present a sclerosing angiomatoid nodular transformation (SANT) case report in a 60 year-old-woman. SANT is an extremely rare benign disease of the spleen that it is radiologically similar to malignant tumors, and clinically difficult to differentiate from other splenic diseases. Splenectomy is both diagnostic and therapeutic in symptomatic cases. The analysis of the resected spleen is necessary to achieve the final diagnosis of SANT.
Asunto(s)
Histiocitoma Fibroso Benigno , Enfermedades del Bazo , Femenino , Humanos , Persona de Mediana Edad , Histiocitoma Fibroso Benigno/diagnóstico por imagen , Histiocitoma Fibroso Benigno/cirugía , Esplenectomía , Enfermedades del Bazo/diagnóstico por imagen , Enfermedades del Bazo/cirugíaRESUMEN
Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumour that occurs in the superficial tissue of extremities of children and young adults. A painless mass in the deep dermis and subcutaneous tissue is the main clinical manifestation. AFH also occurs infrequently in the central nervous system and is relatively common in the cranium. However, spinal canal AFH has not been described yet. We report a rare case of AFH in the cervical canal of a 20-year-old male patient. Microsurgical gross total resection of the tumour was performed, and the diagnosis was confirmed by postoperative pathology. To our knowledge, this is the first case of AFH in the spinal canal.
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Histiocitoma Fibroso Benigno , Histiocitoma Fibroso Maligno , Masculino , Niño , Adulto Joven , Humanos , Adulto , Histiocitoma Fibroso Benigno/diagnóstico por imagen , Histiocitoma Fibroso Benigno/cirugía , Histiocitoma Fibroso Maligno/diagnóstico por imagen , Histiocitoma Fibroso Maligno/cirugíaRESUMEN
BACKGROUND: Treatment of dermatofibromas, beyond surgical excision, has remained inadequate and elusive. Nonsurgical treatment options are desired by both patients and physicians. Erbium glass lasers are known for targeting and remodeling the dermis but have not yet been studied for the treatment of dermatofibromas. OBJECTIVE: To evaluate the efficacy and safety of the fractional 1540-nm erbium glass laser for treatment of dermatofibromas. METHODS: Thirty-five patients representing 44 dermatofibromas completed 2 consecutive monthly treatments with a non-ablative, fractional 1540-nm erbium glass laser and were evaluated at 4, 8, and 12 weeks after the initial treatment. Dermatofibromas were evaluated using patient surveys given before and after the treatments. RESULTS: By week 4, patients reported improvement in color and texture of the dermatofibromas. These improvements were durable through week 12. No complications were reported. CONCLUSIONS: This study demonstrates that the fractional 1540-nm erbium glass laser may be used to improve the color and texture of dermatofibromas and achieve positive patient reported outcomes after only 2 treatments. J Drugs Dermatol. 2022;21(11):1201-1205. doi:10.36849/JDD.6287.
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Histiocitoma Fibroso Benigno , Terapia por Láser , Láseres de Estado Sólido , Humanos , Erbio , Cicatriz/etiología , Histiocitoma Fibroso Benigno/diagnóstico , Histiocitoma Fibroso Benigno/cirugía , Resultado del Tratamiento , Láseres de Estado Sólido/uso terapéutico , Terapia por Láser/efectos adversosRESUMEN
We report the case of a healthy 17-year-old girl who underwent surgery for excision of a painless, rapidly enlarging subconjunctival mass. The mass was found to be tightly adherent to the medial rectus muscle of the left eye, requiring extensive dissection. Histopathology revealed a mass of bland and foamy spindle cells in a storiform pattern that was positive for CD68, PGM1, and factor XIIIA and negative for S-100. The clinical and histopathologic findings are consistent with benign fibrous histiocytoma.
Asunto(s)
Histiocitoma Fibroso Benigno , Femenino , Humanos , Adolescente , Histiocitoma Fibroso Benigno/diagnóstico , Histiocitoma Fibroso Benigno/cirugía , Histiocitoma Fibroso Benigno/patología , Músculos Oculomotores/cirugía , Músculos Oculomotores/patologíaRESUMEN
We report a case of sclerosing angiomatoid nodular transformation(SANT)5 years after remission of diffuse large B-cell lymphoma(DLBCL). A 64-year-old woman was diagnosed a nodular mass at the spleen by a contrast-enhanced CT scan 5 years after the relief for DLBCL. The mass showed accumulation of FDG. Because the possibility of the recurrence of malignant lymphoma could not be ruled out, laparoscopic splenectomy was performed for diagnosis and treatment. Immunohistologically, the resected mass revealed 3 different vascular components pattern(CD31, CD34 and CD8), so we diagnosed SANT. It is difficult to distinguish from malignant lymphoma or cancer even with various examination, so laparoscopic splenectomy is useful for diagnosis and treatment.