目的:动脉瘤性皮肤纤维瘤(ADF)和含铁血黄素皮肤纤维瘤(HDF)是皮肤纤维瘤(DF)的罕见变种,具有独特的组织学特征。虽然HDF传统上被认为是ADF的前身,支持证据有限,病因尚不清楚。回顾性分析2128例DF(2016-2019),探讨ADF的临床病理特征,HDF,和其他DF。
方法:对组织病理学诊断为DF的病例进行ADF和HDF检查。进行单因素分析以比较临床病理特征。
结果:在病例中,168例(7.9%)为ADF,29例(1.4%)为HDF。动脉瘤性皮肤纤维瘤和HDF有几个共同的特征,包括女性发病率较低,更大的尺寸,并增加细胞数量(所有P<0.0001)。值得注意的是,29%的ADF缺乏含铁血黄素沉积。动脉瘤性皮肤纤维瘤主要表现在暴露区域(面部和前臂,两者P<.001)。相比之下,41%的HDF发生在小腿(P=0.018),所有小腿HDFs都表现出静脉淤滞的迹象,将它们与其他HDF区分开来(P<0.0001)。
结论:我们的研究结果表明ADF和HDF之间存在潜在的密切关系。与传统信仰相反,我们还提出了ADF发展为HDF的可能性。身体创伤可能会诱发ADF,HDF可能与下肢静脉淤滞一起从ADF中出现。
OBJECTIVE: Aneurysmal dermatofibroma (ADF) and hemosiderotic dermatofibroma (HDF) are rare variants of dermatofibroma (DF) characterized by distinct histologic features. While HDF is traditionally considered a precursor to ADF, supporting evidence is limited, and the etiology remains unclear. A retrospective analysis of 2128 DF cases (2016-2019) was conducted to investigate the clinicopathologic characteristics of ADF, HDF, and other DFs.
METHODS: Histopathologically diagnosed DF cases were examined for ADF and HDF. Univariate analyses were performed to compare clinicopathologic features.
RESULTS: Among the cases, 168 (7.9%) were ADF and 29 (1.4%) were HDF. Aneurysmal dermatofibroma and HDF shared several common characteristics, including lower occurrence in females, larger size, and increased cellularity (all P < .0001). Notably, 29% of ADFs lacked hemosiderin deposition. Aneurysmal dermatofibroma primarily manifested on exposed areas (face and forearm, both P < .001). In contrast, 41% of HDFs occurred on the lower leg (P = .018), and all lower leg HDFs exhibited signs of venous stasis, distinguishing them from other HDFs (P < .0001).
CONCLUSIONS: Our findings indicate a potential close relationship between ADF and HDF. Contrary to conventional beliefs, we also presented the possibility of ADF progressing into HDFs. Physical trauma may induce ADF, and HDFs may emerge from ADFs in conjunction with venous stasis in the lower extremities.