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Abstract：
Aneurysmal fibrous histiocytoma is an uncommon variant of cutaneous fibrous histiocytomas with a local recurrence rate of 19%. We present a case of aneurysmal fibrous histiocytoma in a 20-year-old female with a regional lymph node metastasis and subsequent satellite nodule. The patient initially presented with a 1-month history of two palpable nodules in left lower anterior shoulder and left axilla. Needle core biopsies from both lesions revealed an atypical spindle cell neoplasm with a differential diagnosis of aneurysmal fibrous histiocytoma and angiomatoid fibrous histiocytoma. The axillary dissection confirmed a metastatic deposit in 1 out of 22 lymph nodes. At 6 months a satellite nodule arose between the resection scar and the axilla histopathologically demonstrating a cellular spindle cell nodule at the dermis subcutaneous junction with large, blood-filled pseudovascular spaces lined by histiocytes. The periphery of the lesion showed collagen trapping without a lymphoplasmacytic infiltrate. The lesional cells were diffusely positive for CD10 and focally for CD68 and Illumina RNA fusion panel sequencing was negative. Herein we present this case of metastatic aneurysmal fibrous histiocytoma with review of the literature and discussion of biology, cytogenetic alterations, and differential diagnosis.
摘要：
动脉瘤性纤维组织细胞瘤是皮肤纤维组织细胞瘤的罕见变体，局部复发率为19％。我们介绍了一名20岁女性的动脉瘤纤维组织细胞瘤，并伴有区域淋巴结转移和随后的卫星结节。该患者最初有1个月的病史，在左下前肩和左腋下有两个可触及的结节。两个病变的针芯活检均显示出非典型的梭形细胞肿瘤，可鉴别诊断为动脉瘤性纤维组织细胞瘤和血管瘤样纤维组织细胞瘤。腋窝清扫术证实22个淋巴结中有1个转移沉积。在6个月时，切除疤痕和腋窝组织病理学上出现了卫星结节，表明真皮皮下交界处有细胞梭形细胞结节，由组织细胞排列的充满血液的假血管间隙。病变的外围显示胶原蛋白捕获，没有淋巴浆细胞浸润。病变细胞对CD10呈弥漫性阳性，对CD68和IlluminaRNA融合组测序呈阴性。在这里，我们介绍了转移性动脉瘤纤维组织细胞瘤的病例，并回顾了文献和生物学的讨论，细胞遗传学改变，和鉴别诊断。
