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首页> 外文期刊>Modern Pathology >Hemosiderotic Fibrohistiocytic Lipomatous Lesion: Ten Cases of a Previously Undescribed Fatty Lesion of the Foot|[sol]|ankle
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Hemosiderotic Fibrohistiocytic Lipomatous Lesion: Ten Cases of a Previously Undescribed Fatty Lesion of the Foot|[sol]|ankle

机译：血脂性纤维组织细胞增生性脂肪病变：十例先前未描述的足部脂肪病变| [sol] |脚踝

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We address the clinicopathologic features of a previously undescribed heavily-pigmented spindle cell proliferation within a circumscribed benign lipomatous lesion that occurs mainly in the ankle region of older females. Patients with "lipoma with fibrohistiocytic proliferation" were retrieved from our files. Slides and clinical information were reviewed, and immunohistochemistry was performed (n = 5). Ten patients with hemosiderotic fibrohistiocytic lipomatous lesions were identified. All cases demonstrated a well-circumscribed fatty lesion with random focal proliferations of plump, slightly pleomorphic spindled cells, scattered inflammatory cells, and abundant iron pigment. The spindled cells had vesicular nuclei with indistinct nucleoli; occasional hyperchromatism was observed. No nuclear cytoplasmic inclusions were identified. The spindled component had a reactive appearance. In most cases, the fatty component, with homogeneously sized adipocytes, predominated. The lesions occurred in the foot/ankle region (8/10, one each cheek and hand) of primarily females (8/10) with a mean age of 50.6 years (range 42–63 years), size of 7.7 cm (range 2.5–17 cm), and prior duration of 3.1 years. Seven of eight patients had a history of prior trauma. The spindled component was positive for vimentin, calponin, CD34, and occasionally KP-1 or lysozyme and negative for caldesmon, S100, and desmin. Follow-up on eight patients revealed four with recurrences or residual disease over three years, requiring re-excision. No cases metastasized or caused patient death (mean 12 years, range 1–23 years). We describe a predominantly fatty lesion that is hemosiderin rich with a "fibrohistiocytic" proliferation, composed of histiocytes, myofibroblasts, and C34-positive fibroblasts, which occurs predominantly in the ankle region of middle-aged females. We believe that this is a reactive process due to antecedent trauma, the inflammatory cells, hemosiderin, mixed spindled cells, and homogeneous non-neoplastic appearance of the fat. HFLL can be distinguished from previously described lesions. Correct identification of hemosiderotic fibrohistiocytic lipomatous lesion is important, as it may locally recur.
机译：我们解决了先前未描述的色素沉着纺锤体细胞增生的临床病理特征，该细胞在主要发生在老年女性的踝部区域的良性脂肪瘤病灶内。从我们的档案中检索出患有“纤维组织细胞增生性脂肪瘤”的患者。幻灯片和临床信息进行了审查，并进行了免疫组织化学（n = 5）。确定了十例伴有铁血性纤维组织细胞增生性脂肪瘤的患者。所有病例均表现出良好的脂肪病灶，肿块随机性局灶性增生，纺锤形细胞略有多形，炎性细胞散在，铁色素丰富。纺锤形细胞具有核仁不清楚的囊泡核。偶尔观察到过色现象。未鉴定出核胞质内含物。纺锤形部件具有反应性外观。在大多数情况下，脂肪成分以及均匀大小的脂肪细胞占主导地位。病变发生在以女性为主的女性（8/10）的脚/踝区域（8/10，脸颊和手各一个），平均年龄为50.6岁（范围42-63岁），大小为7.7 cm（范围2.5） –17厘米），之前的持续时间为3.1年。 8位患者中有7位曾有过外伤史。纺锤体成分对波形蛋白，钙蛋白，CD34呈阳性，偶尔对KP-1或溶菌酶呈阳性，而对卡尔德斯蒙，S100和结蛋白呈阴性。对八名患者的随访发现三年中有四名复发或残留疾病，需要再次切除。没有病例转移或引起患者死亡（平均12年，范围1-23年）。我们描述了一个主要的脂肪病变，富含铁血黄素，具有“纤维组织细胞”增殖，由组织细胞，成肌纤维细胞和C34阳性成纤维细胞组成，主要发生在中年女性的脚踝区域。我们认为，这是由于先前的创伤，炎性细胞，铁血黄素，混合纺锤状细胞以及脂肪的均匀非肿瘤外观而引起的反应过程。 HFLL可以与先前描述的病变区分开。正确鉴定血铁质纤维组织细胞性脂肪瘤病变很重要，因为它可能会局部复发。

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