RESUMO
Abstract Intravascular histiocytosis is a rare condition characterized by the aggregate of histiocytes within dilated dermal vessels. The diagnosis is mainly histophatological and immunohistochemical. We describe a case of a 55 year-old female patient presenting erythematous/purple patches on the breasts, back and limbs. She previously presented ductal carcinoma in the right breast in 2006 which was treated with mastectomy and proceeded to silicone breast implant in 2009. Clinical hypothesis was telangiectatic metastatic carcinoma. Histopathology showed vascular ectasia, thrombosis and recanalization of upper dermis small vessels. On immunohistochemistry, intravascular cells were CD 68+ and negative for estrogen and progesterone receptors, CK7, EMA and AE1/AE3 and endothelial cells were CD64+, leading to the diagnosis of intravascular histiocytosis.
Assuntos
Humanos , Feminino , Silicones/efeitos adversos , Histiocitose/etiologia , Histiocitose/patologia , Dermatopatias Vasculares/etiologia , Dermatopatias Vasculares/patologia , Implante Mamário/efeitos adversos , Imuno-Histoquímica , Trombose Venosa/etiologia , Trombose Venosa/patologia , Dilatação Patológica , Pessoa de Meia-IdadeRESUMO
Intravascular histiocytosis is a rare condition characterized by the aggregate of histiocytes within dilated dermal vessels. The diagnosis is mainly histophatological and immunohistochemical. We describe a case of a 55 year-old female patient presenting erythematous/purple patches on the breasts, back and limbs. She previously presented ductal carcinoma in the right breast in 2006 which was treated with mastectomy and proceeded to silicone breast implant in 2009. Clinical hypothesis was telangiectatic metastatic carcinoma. Histopathology showed vascular ectasia, thrombosis and recanalization of upper dermis small vessels. On immunohistochemistry, intravascular cells were CD 68+ and negative for estrogen and progesterone receptors, CK7, EMA and AE1/AE3 and endothelial cells were CD64+, leading to the diagnosis of intravascular histiocytosis.
Assuntos
Implante Mamário/efeitos adversos , Histiocitose/etiologia , Histiocitose/patologia , Silicones/efeitos adversos , Dermatopatias Vasculares/etiologia , Dermatopatias Vasculares/patologia , Dilatação Patológica , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Trombose Venosa/etiologia , Trombose Venosa/patologiaRESUMO
Dermatofibrossarcoma protuberante é tumor fibro-histiocítico de malignidade intermediária, relativamente incomum e recidivante. Sua variante mais rara é conhecida como atrófica, tipo morfeia ou dermatofibrossarcoma não protuberante, sendo de difícil diagnóstico clínico. Não há critérios dermatoscópicos bem estabelecidos, portanto o diagnóstico é histopatológico. Existem avanços nas áreas da imuno-histoquímica e da genética que auxiliam no diagnóstico e excisão cirúrgica completa. Relatamos um caso de dermatofibrossarcoma atrófico em paciente de 27 anos, revisado na literatura quanto aos aspectos clínicos, dermatoscópicos, histopatológicos e genéticos.
Dermatofibrosarcoma protuberans is an uncommon and relapsing fibrohistiocytic tumor of intermediate malignancy. Its rarest variant is known as atrophic, morphea type or dermatofibrosarcoma non protuberans and its clinical diagnose is difficult. There are not well established dermatoscopic criteria, so the diagnosis is histopathologic. There are advances in immunohistochemical and genetic that help the diagnosis and complete surgical excision. It is reported a case of atrophic dermatofibrosarcoma in a 27 years patient ant it is reviewed the clinical, dermoscopic, histological and genetic aspects.
