Abstract：
Hemosiderotic/aneurysmal variant of dermatofibroma (DF) is infrequent and may be misdiagnosed with malignant lesions. We report the case of a giant (7.6cm) subcutaneous hemosiderotic/aneurysmal DF (H/ADF) of the thigh in a 53-year-old female patient. Internal arterial and venous hypervascularity was seen by spectral Doppler ultrasound. Magnetic resonance image showed a discrete homogeneous hypointense in T1-weighted images (WI) and T2-WI mass, with hyperintense areas in fat-suppressed T2-WI. The histology revealed a monotonous fusocelular proliferation without atypia, positive for CD163, factor XIIIa and CD10. Widely distributed hemosiderin pigment and two blood-filled pseudovascular spaces lacking endothelial lining were present. H/ADF was diagnosed. The mass was removed but surgical margins were affected. The patient did not present local relapse or distant metastasis. H/ADF are unusual cutaneous soft tissue tumours that can be clinically, radiologically and histopathologically confused with malignant lesions such as melanomas, vascular lesions or sarcomas, especially in giant cases.
摘要：
皮肤纤维瘤（DF）的含铁血/动脉瘤变异型很少见，可能会误诊为恶性病变。我们报告了一名53岁女性患者的大腿皮下巨大（7.6cm）含铁血/动脉瘤性DF（H/ADF）的病例。通过频谱多普勒超声可以看到内部动脉和静脉血管过多。磁共振图像在T1加权图像（WI）和T2-WI质量中显示出离散的均匀低信号，在脂肪抑制的T2-WI中具有高强度区域。组织学显示单调的融合细胞增殖，没有异型，CD163、XIIIa因子和CD10阳性。存在广泛分布的含铁血黄素色素和两个缺乏内皮衬里的充满血液的假性血管间隙。诊断为H/ADF。肿块被切除，但手术边缘受到影响。患者未出现局部复发或远处转移。H/ADF是不寻常的皮肤软组织肿瘤，可以在临床上，放射学和组织病理学与恶性病变如黑色素瘤混淆，血管病变或肉瘤，尤其是在巨大的案例中。
