case_images: PMC3420401_01
case_images: Clinical presentation.
case_images: CRIM.PATHOLOGY2011-612416.001.jpg
case_images: PMC3420401_01_CRIM.PATHOLOGY2011-612416.001.jpg
case_images: fig1
case_images: A 31-year-old man presented with an asymptomatic, slowly enlarging, exophytic, brownish nodule of the abdominal wall with surface telangectasia (Figure 1).
case_images: Cellular dermal proliferation of spindle and pleomorphic cells with epidermal hyperplasia, a grenz zone, and prominent blood-filled spaces (hematoxylin and eosin x40).
case_images: CRIM.PATHOLOGY2011-612416.002.jpg
case_images: PMC3420401_01_CRIM.PATHOLOGY2011-612416.002.jpg
case_images: fig2
case_images: Histological findings demonstrated a well-defined unencapsulated dermal nodule with epidermal hyperplasia, an interposed grenz zone (defined as relatively normal collagen forming a boundary between normal epidermis and a dermal lesion) (Figure 2) and superficial involvement of the subcutis.
case_images: Histiocyte-like and fibroblast-like spindle cells intermingled with atypical mononuclear and giant cells, sometimes with foamy cytoplasm, showing nuclear pleomorphism and bizarre nuclei; a mitosis is seen in the upper right (hematoxylin and eosin x100).
case_images: CRIM.PATHOLOGY2011-612416.003.jpg
case_images: PMC3420401_01_CRIM.PATHOLOGY2011-612416.003.jpg
case_images: fig3
case_images: These cells were intermingled with atypical mononuclear and giant cells, sometimes with foamy cytoplasm, showing large, hyperchromatic, irregular nuclei; we found 4 mitotic figures per ten high-power fields (Figure 3).
case_images: Tumor cells are focally positive for CD68 (immunohistochemistry x400).
case_images: CRIM.PATHOLOGY2011-612416.004.jpg
case_images: PMC3420401_01_CRIM.PATHOLOGY2011-612416.004.jpg
case_images: fig4
case_images: Immunohistochemical stains showed focal immunoreactivity for CD68 (Figure 4), while cells were completely negative for S100 protein, HMB45, CD34 and alpha smooth muscle actin.