Marián Švajdler UNLP Košice

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Presentation transcript:

Marián Švajdler UNLP Košice SD-IAP No.478 Marián Švajdler UNLP Košice

Clinical history 86-year old men Tumor of the scalp - biopsy

? Xanthoma ? Metastasis ? – RCC ? PEComa ? Baloon cell melanoma ? Clear cell dermatofibroma ? ... ?

Immunohistochemistry Negative Positive AE1/AE3, CK7, CK8/18 EMA CD10 CD68, CD163 S-100 Melan A, HMB45 Vimentin

vimentin Ki-67

?

CD31

CD34

D2-40

FLI1

CD117

FLI1

Tatsas et al. J Cutan Pathol 2010; 37: 901–906.

Ackerman AB, Guo Y, Vitale PA, Vossaert K Ackerman AB, Guo Y, Vitale PA, Vossaert K. Clues to diagnosis in dermatopathology. Chicago: ASCP Press, 1993; 357.

Angiosarcoma DDX: Immunohistochemistry Tumor of the stomach, sent in consultation as a possible angiosarcoma

CD31

Non-specific FLI positivity CD34 AE1/AE3 Non-specific FLI positivity ERG

CD68 CD163

McKenney JK, Weiss SW, Folpe AL McKenney JK, Weiss SW, Folpe AL. CD31 expression in intratumoral macrophages : a potential diagnostic pitfall. Am J Surg Pathol 2001; 25: 1167

ERG: 100% sensitivity 100% specificity VS McKay KM et al. Expression of ERG, an Ets family transcription factor, distinguishes cutaneous angiosarcoma from histological mimics. Histopathology 2012; 61(5): 989–991. ERG: 100% sensitivity 100% specificity VS FLI1: 100% sensitivity 29% specificity SO FAR .... 

DDX: Xanthoma

DDX: Cutaneous PEComa Mentzel et al., Histopathology 2005, 46, 498–504

Liegel et al, Am J Surg Pathol 2008;32:608–614

Liegel et al, Am J Surg Pathol 2008;32:608–614

DDX: Clear cell dermatofibroma Zelger et al. Histopathology 1997, 30, 64-69

DDX: Clear cell AFX

DDX: Baloon cell melanoma

DDX: Cutaneous atypical lipoma

MDM2 P16

Thank you !