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Atallah J, Garces JC, Loayza E, Carlson JA. Chronic Localized Fibrosing Leukocytoclastic Vasculitis Associated With Lymphedema, Intralymphatic and Intravascular Lymphocytosis, and Chronic Myelogenous Leukemia: A Case Report of Unilateral Erythema Elevatum Diutinum. Am J Dermatopathol 2017; 39:479-484. [DOI: 10.1097/dad.0000000000000802] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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de Menezes S, Mar A, Dowling J, Wright A. A Case of Cutaneous Inflammatory Myofibroblastic Tumor. Pediatr Dermatol 2016; 33:e377-e380. [PMID: 27653445 DOI: 10.1111/pde.12970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) rarely occurs as a primary cutaneous lesion. We report a case of cutaneous IMT in an 8-year-old girl presenting with an ulcerated nodule on the cheek. Although cutaneous IMT poses a diagnostic challenge because of its rarity, excision of the lesion is likely to be curative.
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Affiliation(s)
- Sara de Menezes
- Department of Dermatology, Monash Medical Centre Clayton, Clayton, VIC, Australia
| | - Adrian Mar
- Department of Dermatology, Monash Medical Centre Clayton, Clayton, VIC, Australia
| | - John Dowling
- Department of Pathology, Monash Medical Centre Clayton, Clayton, VIC, Australia
| | - Annaliesa Wright
- Department of Dermatology, Monash Medical Centre Clayton, Clayton, VIC, Australia
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Charrow A, Imadojemu S, Stephen S, Ogunleye T, Takeshita J, Lipoff JB. Cutaneous manifestations of IgG4-related disease (RD): A systematic review. J Am Acad Dermatol 2016; 75:197-202. [DOI: 10.1016/j.jaad.2016.01.046] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 01/18/2016] [Accepted: 01/20/2016] [Indexed: 02/07/2023]
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Leguellec S, Tournier E, Karanian M, Brousset P, Mazereeuw J, Coindre JM, Lamant L. Cutaneous inflammatory myofibroblastic tumours can be anaplastic lymphoma kinase-positive: report of the first four cases. Histopathology 2015; 68:297-302. [DOI: 10.1111/his.12759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/18/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Sophie Leguellec
- Department of Pathology; Institut Universitaire du Cancer Toulouse Oncopole; Toulouse France
- Université Paul-Sabatier; Toulouse France
| | - Emilie Tournier
- Department of Pathology; Institut Universitaire du Cancer Toulouse Oncopole; Toulouse France
- Université Paul-Sabatier; Toulouse France
| | - Marie Karanian
- Department of Dermatology; Larrey Hospital; CHU de Toulouse; Toulouse France
| | - Pierre Brousset
- Department of Pathology; Institut Universitaire du Cancer Toulouse Oncopole; Toulouse France
- Université Paul-Sabatier; Toulouse France
| | - Juliette Mazereeuw
- Department of Dermatology; Larrey Hospital; CHU de Toulouse; Toulouse France
| | | | - Laurence Lamant
- Department of Pathology; Institut Universitaire du Cancer Toulouse Oncopole; Toulouse France
- Université Paul-Sabatier; Toulouse France
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Arisi M, Lorenzi L, Incardona P, Rossi MT, Calzavara-Pinton PG. A case of inflammatory myofibroblastic tumour of the palm in a young girl. J Eur Acad Dermatol Venereol 2015; 30:703-4. [PMID: 25651518 DOI: 10.1111/jdv.13000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Arisi
- Department of Dermatology, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - L Lorenzi
- Department of Pathology, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - P Incardona
- Department of Pathology, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - M T Rossi
- Department of Dermatology, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - P G Calzavara-Pinton
- Department of Dermatology, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
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Szablewski V, Laurent-Roussel S, Rethers L, Rommel A, Van Eeckhout P, Vaneechout P, Camboni A, Willocz P, Copie-Bergman C, Ortonne N. Atypical fibrous histiocytoma of the skin with CD30 and p80/ALK1 positivity and ALK gene rearrangement. J Cutan Pathol 2014; 41:715-9. [PMID: 24666231 DOI: 10.1111/cup.12352] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 03/19/2014] [Accepted: 03/22/2014] [Indexed: 11/30/2022]
Abstract
We report the case of a two patients who presented with a solitary, asymptomatic, angiomatoid nodule on the right thigh. Histopathological finding showed a poorly circumscribed lesion, located in the dermis. The morphological aspect strongly suggested the diagnosis of atypical fibrous histiocytoma (AFH), but surprisingly, the neoplastic cells were diffusely CD30+, with a membrane staining devoid of paranuclear dot. The lesions were tested for p80/ALK1 expression. Surprisingly, we found a diffuse cytoplasmic positivity. Interestingly, using break-apart fluorescent in situ hybridization (FISH), we evidenced an ALK rearrangement in nearly 50% of the neoplastic cells. The expression of CD30 and ALK1 with ALK gene rearrangement raised the possibility of three diagnoses: a primary cutaneous anaplastic large cell lymphoma (ALCL), a cutaneous inflammatory myofibroblastic tumor (IMT), an AFH of the skin associated with ALK gene rearrangement and CD30 positivity. The three hypotheses were discussed and finally, although p80/ALK1 expression and cytogenetic abnormalities in fibrous histiocytoma (FH) are not yet reported to the best of our knowledge, we favored the diagnosis of AFH.
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Affiliation(s)
- Vanessa Szablewski
- Departement de Pathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France
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Anaplastic lymphoma kinase (ALK1) immunohistochemistry in diagnostic dermatopathology; an update. Am J Dermatopathol 2013; 35:403-8; quiz 409-11. [PMID: 23689691 DOI: 10.1097/dad.0b013e31823d2943] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The use of anaplastic lymphoma kinase antibodies (ALK1) as a diagnostic aid has expanded since becoming a routinely available immunohistochemical stain. Because the skin may be the site of a wide variety of hematolymphoid and fibroblastic proliferations, dermatopathologists commonly use ALK1 as part of a broader staining panel in diagnosing soft tissue and cutaneous hematolymphoid neoplasms. Furthermore, new entities and differential diagnostic contexts are emerging, which broaden the utility of ALK1 immunohistochemistry. We review the expanding role of ALK1 immunohistochemistry in contemporary dermatopathology.
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INOUE T, MISAGO N, OKAWA T, NARISAWA Y. Inflammatory myofibroblastic tumor of the skin grossly mimicking squamous cell carcinoma: A case report. J Dermatol 2011; 39:107-10. [DOI: 10.1111/j.1346-8138.2011.01217.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hsiao PF, Wu YH. Angioplasmocellular hyperplasia: A clinicopathologic study of 10 patients. J Am Acad Dermatol 2011; 64:542-7. [DOI: 10.1016/j.jaad.2010.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 03/23/2010] [Accepted: 03/28/2010] [Indexed: 11/16/2022]
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Hassan KS, Cohen HI, Hassan FK, Hassan SK. Unusual case of pancreatic inflammatory myofibroblastic tumor associated with spontaneous splenic rupture. World J Emerg Surg 2010; 5:28. [PMID: 21092210 PMCID: PMC2995784 DOI: 10.1186/1749-7922-5-28] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2010] [Accepted: 11/22/2010] [Indexed: 12/31/2022] Open
Abstract
Background Spontaneous splenic rupture considered a relatively rare but life threatening. The three commonest causes of spontaneous splenic rupture are malignant hematological diseases, viral infections and local inflammatory and neoplastic disorders. We describe a unique and unusual case of inflammatory myofibroblastic tumor of the tail of pancreas presented with massively enlarged spleen and spontaneous splenic rupture. Case presentation A 19 years old male patient with no significant past medical history presented to emergency room with abdominal pain and fatigue. Massively enlarged spleen was detected. Hypotension and rapid reduction of hemoglobin level necessitated urgent laparatomy. About 1.75 liters of blood were found in abdominal cavity. A large tumor arising from the tail of pancreas and local rupture of an enlarged spleen adjacent to the tumor were detected. Distal pancreatectomy and splenectomy were performed. To our knowledge, we report the first case of massively enlarged spleen that was complicated with spontaneous splenic rupture as a result of splenic congestion due to mechanical obstruction caused by an inflammatory myofibroblastic tumor of the tail of pancreas. A review of the literature is also presented. Conclusion Inflammatory myofibroblastic tumor of the tail of pancreas should be included in the differential diagnosis of the etiological causes of massively enlarged spleen and spontaneous splenic rupture.
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Affiliation(s)
- Kamal S Hassan
- Clalit Health Services, Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
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Son SB, Heo YS, Shin WW, Oh TS, Song HJ, Oh CH. A case of cutaneous inflammatory myofibroblastic tumor. Ann Dermatol 2010; 22:91-5. [PMID: 20548893 DOI: 10.5021/ad.2010.22.1.91] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Revised: 07/22/2009] [Accepted: 07/22/2009] [Indexed: 11/08/2022] Open
Abstract
Pseudo-inflammatory tumors are also known as plasma cell granuloma, inflammatory pseudo-tumor and inflammatory myofibroblastic tumor, and these tumors are a group of highly variable proliferations of myofibroblastic cells that are associated with a prominent inflammatory infiltrate. This tumor is known to most commonly occur in the lungs, bladder and gastrointestinal system with only a few cases having been reported in the skin. A previously healthy 26-year-old man presented with a 6-year history of an intermittently pruritic lesion on his back. On the histologic examination, there were spindle cells in fascicles and a mixed inflammatory cellular infiltrate of plasma cells and lymphocytes. A diagnosis of inflammatory fibroblastic tumor was made and the nodule was surgically removed. We report here on an additional case of this rare cutaneous entity, and it is probably the first such report from Korea.
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Affiliation(s)
- Soo Bin Son
- Department of Dermatology, College of Medicine, Korea University, Seoul, Korea
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Chen YF, Chao CM, Liu HN. Cutaneous plasma cell granuloma: report of a case with novel histologic and immunohistochemical findings. Int J Dermatol 2009; 48:409-11. [DOI: 10.1111/j.1365-4632.2009.03939.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Inflammatory pseudotumor of lymph nodes (IPT-LN) represents an unusual cause of lymphadenitis of unknown etiology. Upon the observation of a case of IPT-LN associated with Treponema pallidum (Tp) infection, we analyzed a series of 9 IPT-LN and 9 extranodal IPT (spleen, 4 cases; lung, orbit, gut, skin, and liver) for the presence of Tp, using a polyclonal antibody anti-Tp. At the time of biopsy, none of the patients was suspected for luetic infection, nor specific serologic tests were available. IPT-LN areas extensively involved the nodal parenchyma in 4 cases, whereas they were focal in the remaining 5 cases. Capsular thickening and inflammation (6/9), venulitis (3/9), small granulomas (3/9), and follicular hyperplasia (7/9) were observed in the associated lymphoid parenchyma. Tp were detected in 4/9 cases of LN-IPT and in none of the extranodal IPT. Tp were extremely abundant within the IPT areas and in the perivascular tissues in the surrounding parenchyma, whereas they were scattered within the capsule. In Tp+ cases, marked follicular hyperplasia was the single distinctively associated feature. Double immunostains revealed that Tp were predominantly contained in the cytoplasm of CD11c+ CD163+ macrophages, some of which co-expressed HLA-DR. In addition, scattered S100+ interdigitating dendritic cells also showed intracytoplasmic Tp. This study shows that a significant number of IPT-LN is associated with Tp infection. A spirochetal etiology can be suspected in cases of IPT-LN, independently from the extension of the lesions, especially when pronounced follicular hyperplasia is found. Infection by Tp of macrophages and dendritic cells are in keeping with in vitro data and indicate that immune mediated mechanisms may be involved in the pathogenesis of the lesions.
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González-Vela MC, Val-Bernal JF, Arce FP, Gómez-Roman J, González-López MA, Fernández-Llaca JH. Presence of human herpesvirus-8 in inflammatory myofibroblastic tumor of the skin. J Eur Acad Dermatol Venereol 2007; 21:399-401. [PMID: 17309471 DOI: 10.1111/j.1468-3083.2006.01876.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
A broad and diverse spectrum of vasculitic syndromes exists. These syndromes affect the skin with varying levels of associated systemic manifestations, running the gamut from a self-limited, localized, cutaneous phenomenon to rapidly progressive, multiorgan disease. The majority of cases of cutaneous vasculitis will show a neutrophilic small vessel vasculitis that can be either a primary (idiopathic) disorder (eg, cutaneous leukocytoclastic angiitis) or a secondary disorder that is associated with drugs, infection (eg, streptococcal infection, viral hepatitis), or underlying disease (eg, connective tissue disease, malignancy). Biopsy is the gold standard for the diagnosis of cutaneous vasculitis and also necessary for the detection of cutaneous vascular immune complexes by direct immunofluorescence. Based on the type of vessel disrupted by inflammation (small and/or muscular), the distribution of vasculitis in the dermis and subcutis, and predominate inflammatory cell-type mediating vessel wall damage, a list of relevant differential diagnoses can be generated. This histologic information coupled with extravascular findings such as tissue eosinophilia, tissue neutrophilia, and/or granulomas, plus pathophysiologic markers such as direct immunofluorescent examination for immune complexes and serologic evaluation for antineutrophil cytoplasmic antibodies allows for more accurate diagnosis of specific vasculitic entities. Herein, we review both primary and secondary vasculitic syndromes that affect the skin and show a small vessel neutrophilic mediated vasculitis.
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Affiliation(s)
- J Andrew Carlson
- Divisions of Dermatology and Dermatopathology, Albany Medical College, Albany, NY 12208, USA.
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