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Perrin C, Coutts M. Onychomatricoma is not a subtype of superficial acral fibromyxoma: Can immunohistochemistry help in the differential diagnosis? J Cutan Pathol 2024; 51:439-440. [PMID: 38527773 DOI: 10.1111/cup.14616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/06/2024] [Accepted: 03/16/2024] [Indexed: 03/27/2024]
Affiliation(s)
- Christophe Perrin
- Laboratoire Central d'Anatomie Pathologique, University Hospital of Nice, Nice, France
| | - Michael Coutts
- Department of Cellular Pathology, Maidstone Hospital, Kent, UK
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2
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Perrin C. Onychomatricoma Versus Superficial Acral Fibromyxoma: Nestin Immunohistochemistry Is a Help in the Differential Diagnosis. Am J Dermatopathol 2024; 46:328-329. [PMID: 38354374 DOI: 10.1097/dad.0000000000002628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Affiliation(s)
- Christophe Perrin
- Laboratoire Central d'Anatomie Pathologique, Nice University Hospital, Nice, France
- Nail's Dermatology Consultations, Cannes, France
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3
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Riebesell SA, Lazaro JS, Kirby D, Rivlin M. A Case of Superficial Acral Fibromyxoma of the Index Finger. Cureus 2024; 16:e60518. [PMID: 38883029 PMCID: PMC11180493 DOI: 10.7759/cureus.60518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2024] [Indexed: 06/18/2024] Open
Abstract
Superficial acral fibromyxoma (SAFM) is a rare, slow-growing benign soft tissue tumor that is typically asymptomatic in nature and usually affects the acral regions of the hands and feet. The majority of these lesions are subungual. Excisional biopsy is the primary treatment modality. Despite the distinct clinical and histopathological features, misidentification of this slow-growing tumor persists. This case report contributes to the existing literature by delineating the clinicopathologic features, radiographic and MRI findings, and treatment strategies of SAFM.
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Affiliation(s)
| | | | - David Kirby
- Hand Surgery, Rothman Orthopedic Institute, Philadelphia, USA
| | - Michael Rivlin
- Hand Surgery, Rothman Orthopedic Institute, Philadelphia, USA
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Liu Y, Zou D, Huang Q, Wang L. RB1 loss in the mesenchymal component of onychomatricoma. J Cutan Pathol 2023; 50:1094-1098. [PMID: 37596842 DOI: 10.1111/cup.14514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND Onychomatricoma is a nail neoplasm that usually presents as longitudinal nail plate thickening, involving either the partial or whole nail. Histopathologically, it is characterized by deep invaginations of the proliferating nail matrix and proliferation of CD34+ and CD10+ spindle cells with collagenous to myxoid stroma. Onychomatricoma has been considered a fibroepithelial neoplasm. Recently, RB1 loss has been verified using array comparative genomic hybridization. METHODS This study investigated the RB1 status in onychomatricoma with morphological methods. RESULTS Six patients with onychomatricoma were included in the study. RB1 status was assessed using immunohistochemical staining and fluorescence in situ hybridization. Immunohistochemical staining showed that all six cases experienced RB1 loss in the mesenchymal component of onychomatricoma but not in the proliferated nail matrix. Fluorescence in situ hybridization in five cases showed a monoallelic deletion of the RB1 locus in the mesenchymal component but not in the proliferated nail matrix. CONCLUSIONS RB1 loss was observed only in the mesenchymal component of onychomatricoma. Our findings suggest that the proliferated nail matrix in onychomatricoma represents reactive hyperplasia of various degrees secondary to neoplastic mesenchymal proliferation. This indicates that onychomatricoma should be recognized as an RB1-deleted soft tissue neoplasm rather than a fibroepithelial neoplasm.
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Affiliation(s)
- Yu Liu
- Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xian, China
| | - Daopei Zou
- Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xian, China
| | - Qiong Huang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Lei Wang
- Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xian, China
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Chaima K, Emna B, Fatma H, Khadija S, Sonia B, Abderrahman M, Tahya B, Hamida T. A longstanding tumor with toe deformity. Int J Rheum Dis 2023; 26:2110-2113. [PMID: 37287432 DOI: 10.1111/1756-185x.14770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/10/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Affiliation(s)
- Kouki Chaima
- Department of Dermatology, Hospital of Hedi Chaker, Sfax, Tunisia
| | - Bahloul Emna
- Department of Dermatology, Hospital of Hedi Chaker, Sfax, Tunisia
| | - Hammami Fatma
- Department of Dermatology, Hospital of Hedi Chaker, Sfax, Tunisia
| | - Sellami Khadija
- Department of Dermatology, Hospital of Hedi Chaker, Sfax, Tunisia
| | - Boudaya Sonia
- Department of Dermatology, Hospital of Hedi Chaker, Sfax, Tunisia
| | | | - Boudawara Tahya
- Anatomopathology Department, Hospital of Habib Bourguiba, Sfax, Tunisia
| | - Turki Hamida
- Department of Dermatology, Hospital of Hedi Chaker, Sfax, Tunisia
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Perrin C, Pedeutour F, Coutts M, Ambrosetti D, Dadone-Montaudié B. Onychomatricoma: a clinicopathological, immunohistochemical, and molecular study of 10 cases highlighting recurrent RB1 deletion and the potential diagnostic value of LEF-1. Histopathology 2023; 82:767-778. [PMID: 36647795 DOI: 10.1111/his.14864] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/02/2023] [Accepted: 01/07/2023] [Indexed: 01/18/2023]
Abstract
AIMS Onychomatricoma (OM), an uncommon benign fibroepithelial neoplasm of the nail unit, is sometimes diagnostically challenging for clinicians and pathologists. OM consistently expresses CD34, but no specific immunohistohemical markers or recurrent genetic alterations have been identified to date. Recent studies have suggested that Wnt signalling is a key molecular characteristic of OM. METHODS AND RESULTS Ten cases were analysed: four classical OM including two with pleomorphic cells; two superficial acral fibromyxoma-like variants of OM; three micropapilliferum variants of OM including one with pleomorphic cells; and one proliferating variant of OM. Immunohistochemically, the spindle cells were positive with CD34 (n = 10) and CD99 (n = 1), with focal reactivity for CD10 (n = 5). The epithelial component of the tumours expressed immunopositivity for LEF-1. Using array comparative genomic hybridization (aCGH), we demonstrated that all OM, including its variants that were tested (n = 8), harboured a few copy number alterations with losses of whole or part of chromosome 13 including the RB1 gene (n = 8) and chromosome 16 (n = 6). CONCLUSION We report a recurrent loss of RB1 (13q) as a possible driver molecular event in OM indicating a relationship between OM and other lesions of the spectrum of the so-called '13q/RB1' family of tumours. We did not identify a role for the Wnt/beta-catenin signalling pathway, as has been proposed in a recent study. LEF-1 could be a potential sensitive and specific marker of OM and should be used in the differential diagnosis between OM, superficial acral fibromyxoma, and the CD34-positive fibrosing family of tumours.
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Affiliation(s)
- Christophe Perrin
- Laboratoire Central d'Anatomie Pathologique, Nice University Hospital, Nice, France.,Nail's Dermatology Consultations, Cannes, France
| | - Florence Pedeutour
- Department of Pathology and Molecular Oncology, Nice University Hospital, Nice, France.,Laboratory of Solid Tumors Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN) CNRS UMR 7284/INSERM U1081, University of Côte d'Azur (UCA), Nice University Hospital, Nice, France
| | - Michael Coutts
- Department of Cellular Pathology, Maidstone Hospital, Kent, UK
| | - Damien Ambrosetti
- Laboratoire Central d'Anatomie Pathologique, Nice University Hospital, Nice, France
| | - Bérengère Dadone-Montaudié
- Department of Pathology and Molecular Oncology, Nice University Hospital, Nice, France.,Laboratory of Solid Tumors Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN) CNRS UMR 7284/INSERM U1081, University of Côte d'Azur (UCA), Nice University Hospital, Nice, France
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Sivasaththivel M, Howard MD, Yazdabadi A. Acral fibromyxoma: a rare plantar nodule. BMJ Case Rep 2022; 15:e247565. [PMID: 35750432 PMCID: PMC9234790 DOI: 10.1136/bcr-2021-247565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/04/2022] Open
Abstract
Acral fibromyxomas are benign tumours ranging in size between 0.6 and 5 cm, commonly found around the nailbed. The often asymptomatic presentation of acral fibromyxomas means that there is often a delay in their diagnosis and subsequent treatment. The objective of this paper is to present the unique case of a fibromyxoma present in the acral region, as well as a review of the literature.
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Affiliation(s)
| | | | - Anousha Yazdabadi
- Medical Education, University of Melbourne, Parkville, Melbourne, Australia
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A Rare Case of Myxochondroid Metaplasia of the Plantar Foot With Review of Histopathological Mimics. Am J Dermatopathol 2022; 44:e113-e116. [PMID: 35503890 DOI: 10.1097/dad.0000000000002214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Chondromyxoid metaplasia can rarely lead to the formation of a distinctive tumor-like proliferation in the plantar foot. This is thought to represent a reactive or reparative process, possibly due to chronic trauma. For the unwary dermatopathologist, this could represent a diagnostic challenge. Herein, we review the clinical, histopathological, and molecular presentation of an athletic 17-year-old boy with a soft tissue mass arising in the right plantar foot. Microscopic examination showed a relatively circumscribed proliferation of spindle cells with abundant chondromyxoid stroma, hyalinization, and diffuse ERG reactivity. We also review characteristics of this entity that help differentiate it from clinical and histopathologic mimics and postulate possible links with soft tissue chondromas and immature chondroid choristoma.
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Pangti R, Mehta N, Gupta S, Das P, Bhari N. Slowly progressive nodular growth of the nail bed in a young adult. Indian J Dermatol Venereol Leprol 2021; 88:372-375. [PMID: 33871189 DOI: 10.25259/ijdvl_69_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 10/01/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Rashi Pangti
- Departments of Dermatology and Venereology and Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Nikhil Mehta
- Departments of Dermatology and Venereology and Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Departments of Dermatology and Venereology and Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Prasenjit Das
- Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Neetu Bhari
- Departments of Dermatology and Venereology and Pathology, All India Institute of Medical Sciences, New Delhi, India
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Habeeb O, Korty KE, Azzato EM, Astbury C, Farkas DH, Ko JS, Billings SD. EWSR1-SMAD3 rearranged fibroblastic tumor: Case series and review. J Cutan Pathol 2020; 48:255-262. [PMID: 32901982 DOI: 10.1111/cup.13870] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/23/2020] [Accepted: 08/31/2020] [Indexed: 11/29/2022]
Abstract
We report the largest series to date (N = 6) of EWSR1-SMAD3 rearranged fibroblastic tumor. Initially described in 2018, the tumor features a marked female predominance (F:M, 5:1, mean age 44-years, median age 45.5 years; range 27-57), with most cases (5/6, 83%) arising in acral locations (4 on foot/toe, 1 on hand). One case presented on the lower extremity. The lesions presented as nodules and were composed of short, variably cellular, intersecting fascicles of uniform spindled cells in a collagenous to myxoid stroma. In four cases, the tumor abutted the epidermis without a grenz zone. In one case, there was an abrupt transition to a central, acellular hyalinized area. Two other cases had admixed smaller collagenous areas, reminiscent of collagen rosettes. One had a concentric arrangement of tumor cells around blood vessels. Mitotic activity was low (<1/10 HPFs). All were positive for ERG by immunohistochemistry and negative for CD34 (6/6). An EWSR1-SMAD3 fusion was identified in three cases tested by next-generation sequencing (3/3). Rearrangement of EWSR1 by fluorescence in situ hybridization was showed in 1/1 case. Our series reaffirms prior findings and expands the known histopathologic spectrum of this emerging entity.
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Affiliation(s)
- Omar Habeeb
- Department of Anatomic Pathology, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand
| | - Katelen E Korty
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio, USA
| | | | | | - Daniel H Farkas
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jennifer S Ko
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio, USA
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Cohen PR, Alpert RS, Calame A. Cellular Digital Fibroma: A Comprehensive Review of a CD34-Positive Acral Lesion of the Distal Fingers and Toes. Dermatol Ther (Heidelb) 2020; 10:949-966. [PMID: 32728848 PMCID: PMC7477026 DOI: 10.1007/s13555-020-00418-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Indexed: 12/13/2022] Open
Abstract
Cellular digital fibroma is a benign fibrous lesion that typically occurred on either a finger or a toe. Cellular digital fibroma was introduced as a distinctive cluster of differentiation 34 (CD34)-positive lesion in July 2005. Cellular digital fibroma has been described in 20 patients: 12 men and 8 women. The patients ranged in age from 27 to 83 years old (median, 52 years old) at diagnosis. The tumor had been present from 2 months to 2 years (median, 11 months) prior to seeking medical attention. The cellular digital fibroma was usually slowly growing and asymptomatic; there has been no prior history of trauma at the tumor site. The lesion typically presented as either an erythematous or a flesh-colored, solitary papule of 5 mm or smaller. It frequently occurred on either the dorsal, lateral or ventral side of a digit. Yet, some of the lesions were located on the nail fold of the digit. Cellular digital fibroma shows a prominent cellular proliferation of spindle-shaped fibroblasts, without any atypia or mitoses, that extends from the papillary into the upper reticular dermis; diffuse and strongly positive CD34 staining is present throughout the entire tumor. There is no erosion by the tumor of the bony phalanx. Other acral tumors, such as superficial acral fibromyxoma (which also has diffuse strongly positive CD34 staining) and acquired digital fibrokeratoma (which is either CD34-negative or only focal CD34 positive), are in the clinical and pathologic differential diagnosis of cellular digital fibroma. Conservative complete excision is the treatment of cellular digital fibroma; however, even for tumors that have only been partially removed during biopsy, recurrence has not been observed. In conclusion, cellular digital fibroma is a unique CD34-positive acral lesion of the distal fingers and toes whose diagnosis requires correlation of the clinical morphology and the pathologic features of the tumor.
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Affiliation(s)
- Philip R Cohen
- San Diego Family Dermatology, National City, CA, USA.
- Touro University California College of Osteopathic Medicine, Vallejo, CA, USA.
- , 10991 Twinleaf Court, San Diego, CA, 92131, USA.
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12
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Painful subungual nodule. JAAD Case Rep 2020; 6:531-533. [PMID: 32490118 PMCID: PMC7256240 DOI: 10.1016/j.jdcr.2020.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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13
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Moulonguet I, Goettmann S, Zaraa I. Superficial Acral Fibromyxoma With Cartilaginous Metaplasia. Am J Dermatopathol 2019; 41:316-317. [PMID: 29360681 DOI: 10.1097/dad.0000000000001103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | | | - Ines Zaraa
- Hôpital Bichat Service de Dermatologie, Paris, France
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Kara Polat A, Gore Karaali M, Turgut Erdemir AV, Koku Aksu AE, Leblebici C, Gurel MS. Superficial acral fibromyxoma in the heel with new vascular features on dermoscopy. J Cutan Pathol 2018; 45:416-418. [PMID: 29446850 DOI: 10.1111/cup.13128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 02/08/2018] [Accepted: 02/09/2018] [Indexed: 12/14/2022]
Abstract
Superficial acral fibromyxoma (SAFM) is an uncommon mesenchymal soft tissue tumor with a predilection for the acral extremites and nail bed involvement. SAFM is diagnosed with clinicopathological and immunohistochemical examination. Awareness of this rare tumor is important because of amounts of benign and malignant neoplasms. We report a case of SAFM in a rare localization in the heel with a new finding on dermoscopy.
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Affiliation(s)
- Asude Kara Polat
- Department of Dermatology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Muge Gore Karaali
- Department of Dermatology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Asli V Turgut Erdemir
- Department of Dermatology, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, Turkey
| | - Ayse E Koku Aksu
- Department of Dermatology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Cem Leblebici
- Department of Pathology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Mehmet S Gurel
- Department of Dermatology, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, Turkey
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