Myxoid atypical fibroxanthoma: a previously undescribed variant

Patton, Ashley; Page, Robert N.; King, Roy

doi:10.1111/j.1600-0560.2009.01255.x

Cited by 26 publications

(18 citation statements)

References 64 publications

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“…The myxoid pattern of AFX has only recently been described in the literature in a series of 4 cases. 38 Osteoclast-like giant cells seem to be infrequent in AFX (2 cases in this series) and must be distinguished from tumor giant cells, which show larger, more atypical, and pleomorphic nuclei. They were CD68 positive and seem to represent fused macrophages.…”

Section: Discussionmentioning

confidence: 91%

Atypical Fibroxanthoma: A Histological and Immunohistochemical Review of 171 Cases

Beer¹,

Drury²,

Heenan³

2010

The American Journal of Dermatopathology

121

140

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The clinical and histological features of 171 atypical fibroxanthomas (AFX) from a single institution in Western Australia are outlined. This area experiences high levels of solar radiation, and all assessable biopsies showed solar elastosis. Patients were aged between 41 and 97 years (median age 74), with 76% of tumors occurring in men (male to female ratio approximately 3 to 1). Most tumors were small, with a median diameter of 10 mm and a range of 4-35 mm. Only 5% exceeded 20 mm in diameter. Most AFX were well-circumscribed dermal lesions, with limited invasion of subcutis in a minority. Histological variants identified included keloidal (n = 8), clear cell (n = 3), and granular cell (n = 3), plaque like (n = 4), and myxoid (n = 1). Bland cytological appearances (spindle cell nonpleomorphic AFX) were noted in 5 tumors, with osteoclast-like giant cells in 2. Features suggesting regression were present in 22 cases. Two cases recurred locally, none metastasized. No tumors expressed melanocytic or epithelial markers. Seventy-four percent of cases expressed smooth muscle actin, typically strongly and diffusely. No AFX stained with desmin. Only 1 of 50 cases was CD117 positive. In conclusion, AFX may show a wide range of histological appearances, and a panel of immunohistochemical markers is essential to make the correct diagnosis. Histological mimics, such as poorly differentiated squamous cell carcinoma, must be carefully excluded. Specific diagnosis is important because there seems to be a very low risk of recurrence or metastasis despite the frequently alarming histology.

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Section: Discussionmentioning

confidence: 91%

Atypical Fibroxanthoma: A Histological and Immunohistochemical Review of 171 Cases

Beer¹,

Drury²,

Heenan³

2010

The American Journal of Dermatopathology

121

140

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“…1,2 Absence of immunohistochemical expression of S100 protein, cytokeratins (CKs), desmin, and CD34 is considered a diagnostic requirement. 19 Clear cell AFX is a rare variant with only 12 cases reported up to the present date, all of them as case reports, except for one small series of 3 cases. [5][6][7][8][9] Recently, Merkel cell polyomavirus (MCPyV) DNA has been detected in 17%-29% of AFX cases, but the pathogenetic role for MCPyV in this neoplasm remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Clear Cell Atypical Fibroxanthoma: Clinicopathological Study of 6 Cases and Review of the Literature With Special Emphasis on the Differential Diagnosis

Tardío

Pinedo

Aramburu

et al. 2016

The American Journal of Dermatopathology

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Atypical fibroxanthoma (AFX) is an uncommon dermal-based neoplasm arising on the sun-damaged skin of elderly people. Clear cell AFX is a rare variant with only 12 cases reported until the present date, all of them as case reports, except for 1 small series of 3 cases. The authors report 6 new cases and review the literature with special emphasis on the differential diagnosis. The clear cell variant represents 5% of AFX from their files. Histopathologically, it consists of sheets of epithelioid, pleomorphic cells, intermixed with a varying number of giant multinucleated and spindle cells, the latter arranged in a fascicular pattern. All cell types predominantly exhibit a clear, microvacuolated cytoplasm with well-demarcated cell borders. The clinical and immunohistochemical features of this variant are similar to those of the classic type. Clear cell AFX must be differentiated from other cutaneous clear cell neoplasms, some of them with an aggressive clinical behavior, including clear cell melanoma, primary cutaneous and metastatic clear cell carcinomas, clear cell sarcoma, pleomorphic liposarcoma, tumor of perivascular epithelioid cells, and distinctive dermal clear cell mesenchymal neoplasm. The clinical presentation and immunohistochemical profile play a key role in the differential diagnosis.

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“…Myxoid change in AFX is rare, and it would be more likely on statistical grounds that a malignant myxoid cutaneous tumour represents another diagnostic entity. 56 …”

Section: Keloidal Afxmentioning

confidence: 97%

Atypical fibroxanthoma: differential diagnosis from other sarcomatoid skin lesions

Scolyer¹,

Murali²,

McCarthy³

et al. 2010

Diagnostic Histopathology

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Myxoid atypical fibroxanthoma: a previously undescribed variant

Abstract: Myxoid change in AFX is rare and previously undescribed in the English literature. Myxoid change may be a prominent finding in benign and malignant cutaneous tumors and awareness of this variant of AFX will avoid misdiagnosis.

Cited by 26 publications

References 64 publications

Atypical Fibroxanthoma: A Histological and Immunohistochemical Review of 171 Cases

Atypical Fibroxanthoma: A Histological and Immunohistochemical Review of 171 Cases

Clear Cell Atypical Fibroxanthoma: Clinicopathological Study of 6 Cases and Review of the Literature With Special Emphasis on the Differential Diagnosis

Atypical fibroxanthoma: differential diagnosis from other sarcomatoid skin lesions

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