case_images: PMC3400351_01
case_images: Gross specimen showing a section of skin with an ulcerative lesion (left) with necrotic tissue (right) that detached during resection.
case_images: CRIM2012-798629.001.jpg
case_images: PMC3400351_01_CRIM2012-798629.001.jpg
case_images: fig1
case_images: His past medical history consisted of hypertension and a left upper extremity necrotic mass, 4.4 x 3 x 3 cm, that was resected 5 weeks ago (Figure 1).
case_images: Section of skin showing malignant cells infiltrating the epidermis and dermis but without subcutaneous invasion (H&E 5x).
case_images: CRIM2012-798629.002.jpg
case_images: PMC3400351_01_CRIM2012-798629.002.jpg
case_images: fig2
case_images: Pathology revealed high-grade soft tissue undifferentiated sarcoma/pleomorphic malignant fibrous histiocytoma with clear resection margins tumor cells restricted to the dermis (Figure 2) without evidence of lymphovascular invasion.
case_images: Slide showing giant malignant cells (arrow) in an inflammatory background (H&E) 40x.
case_images: CRIM2012-798629.003.jpg
case_images: PMC3400351_01_CRIM2012-798629.003.jpg
case_images: fig3
case_images: Giant malignant cells on an inflammatory background were identified on H&E stain (Figure 3.) Immunohistochemistry of the pathology specimen was positive for CD 68 and CD 99 (Figures 4 and 5) and negative for S-100, HMB-45, SMA, pan-keratin, factor 13-A, and desmin.
case_images: Malignant cells showing positive immunohistochemistry for CD 68 (20x).
case_images: CRIM2012-798629.004.jpg
case_images: PMC3400351_01_CRIM2012-798629.004.jpg
case_images: fig4
case_images: Giant malignant cells on an inflammatory background were identified on H&E stain (Figure 3.) Immunohistochemistry of the pathology specimen was positive for CD 68 and CD 99 (Figures 4 and 5) and negative for S-100, HMB-45, SMA, pan-keratin, factor 13-A, and desmin.
case_images: Malignant cells showing positive Immunohistochemistry for CD 99 (20x).
case_images: CRIM2012-798629.005.jpg
case_images: PMC3400351_01_CRIM2012-798629.005.jpg
case_images: fig5
case_images: Giant malignant cells on an inflammatory background were identified on H&E stain (Figure 3.) Immunohistochemistry of the pathology specimen was positive for CD 68 and CD 99 (Figures 4 and 5) and negative for S-100, HMB-45, SMA, pan-keratin, factor 13-A, and desmin.
case_images: Presurgical chest radiography negative for metastasis.
case_images: CRIM2012-798629.006.jpg
case_images: PMC3400351_01_CRIM2012-798629.006.jpg
case_images: fig6
case_images: At the time, a chest X-ray was negative for metastatic disease (Figure 6).
case_images: (a) Chest radiography showing multiple bilateral pulmonary nodules suggesting metastasis. (b) CT-scan of the chest revealing numerous pulmonary nodules suspicions for metastasis.
case_images: CRIM2012-798629.007.jpg
case_images: PMC3400351_01_CRIM2012-798629.007.jpg
case_images: fig7
case_images: A chest X-ray and CT scan of the thorax both revealed numerous bilateral pulmonary nodules (Figures 7(a) and 7(b)) suspicious for metastasis with left axillary and left superior diaphragmatic lymphadenopathy with splenomegaly and bilateral adrenal nodules.