Atypical fibroxanthoma: differential diagnosis from other sarcomatoid skin lesions

Scolyer, Richard A.; Murali, Rajmohan; McCarthy, Stanley W.; Thompson, John F.

doi:10.1016/j.mpdhp.2010.06.007

Cited by 8 publications

(3 citation statements)

References 57 publications

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“…Immunohistochemistry confirmed the diagnosis of soft tissue sarcoma with AFX/ UPS morphology. [7][8][9] Soft tissue sarcomas mainly arise in the extremities and trunk, and only 5%-20% of them arise in the head and neck. 10 According to literature data, the most common soft tissue sarcoma in the head and neck area is rhabdomyosarcoma, followed by UPS, fibrosarcoma and neurogenic sarcoma.…”

Section: Discussionmentioning

confidence: 99%

Undifferentiated pleomorphic sarcoma in oropharyngeal mucosa of patients with multiple basal cell carcinomas

et al. 2021

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Malignant mesenchymal tumors of oropharyngeal mucosa are rare. Those with fibroblastic and histiocytic differentiation in the skin are called atypical fibroxanthoma (AFX) and in the soft tissue undifferentiated pleomorphic sarcoma (UPS). Here we present a case of an older patient with a history of multiple basal cell carcinomas and recently with a rapidly growing polypoid lesion in the mucosa of posterior oropharyngeal wall with AFX/UPS morphology. The differential diagnosis, histological pitfalls of this poorly characterized mesenchymal lesions, and the challenges associated with treatment are discussed.

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Section: Discussionmentioning

confidence: 99%

Undifferentiated pleomorphic sarcoma in oropharyngeal mucosa of patients with multiple basal cell carcinomas

et al. 2021

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“…The constituent tumor cells may be positive for procollagen-1, CD10, CD68, CD99, and SMA. Importantly, these markers may be positive in other sarcomatoid tumors and are only meaningful after negative expression for SOX10/S100 or cytokeratins/p63/p40 [36]. Desmin and ERG should be considerations to exclude leiomyosarcoma and spindled angiosarcoma, respectively.…”

Section: B Cmentioning

confidence: 99%

Pleomorphic dermal sarcoma in a man with HIV: report with next-generation sequencing analysis and review of the atypical fibroxanthoma/pleomorphic dermal sarcoma spectrum

Chen

Eichenfield²,

Orme³

et al. 2019

Dermatology Online Journal

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“…Unfortunately, there are not specific antibodies that highlight AFX, and diagnosis thus principally relies upon a lack of staining for a panel of antibodies, including melanocytic, epithelial and smooth muscle markers 4,5 . While markers such as CD10, procollagen and CD99 have some utility in diagnosing AFX, the antibodies generally show limited specificity and sensitivity 5–8 . There is, therefore, great interest in identifying specific stains that will assist in establishing a diagnosis of AFX.…”

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confidence: 99%

CD163 is not a sensitive marker for identification of atypical fibroxanthoma

Beer

2011

J Cutan Pathol

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The histopathological features of atypical fibroxanthoma (AFX) overlap with those of poorly differentiated carcinoma, melanoma and leiomyosarcoma in the skin. As there are no specific stains to identify AFX, the diagnosis is essentially one of exclusion and requires completion of a panel of immunostains. Recently, it has been suggested that the macrophage/monocyte-specific marker CD163 is of value in identifying AFX. To investigate this claim, 57 AFX were stained for CD163. Only 21 of 57 (37%) of AFX stained positively, and intratumoral macrophages confounded interpretation of the stain at times. In four cases, it was not possible to definitively interpret the tumor staining reaction because of this effect. While a lack of stainable CD163 antigenicity may indicate that AFX is not of histiocytic lineage, it is conceivable that expression of the antigen has been lost for some reason in cells that are in fact of macrophage lineage. In summary, CD163 only stains a minority of AFX and staining results can be difficult to interpret. CD163 is therefore of very limited value in the diagnosis of AFX. Beer TW. CD163 is not a sensitive marker for identification of atypical fibroxanthoma.

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Atypical fibroxanthoma: differential diagnosis from other sarcomatoid skin lesions

Cited by 8 publications

References 57 publications

Undifferentiated pleomorphic sarcoma in oropharyngeal mucosa of patients with multiple basal cell carcinomas

Undifferentiated pleomorphic sarcoma in oropharyngeal mucosa of patients with multiple basal cell carcinomas

Pleomorphic dermal sarcoma in a man with HIV: report with next-generation sequencing analysis and review of the atypical fibroxanthoma/pleomorphic dermal sarcoma spectrum

CD163 is not a sensitive marker for identification of atypical fibroxanthoma

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