Case Number : Case 1592 - 02 August Posted By: Guest

My differential is between cellular dermatofibroma with atypical/monster cells vs dermatofibrosarcoma protruberans. Should perform IHQ: CD34, FXIII, SM;, there is epidermal induction (much more frequent in dermatofibroma than DFSP), pseudovascular spaces and an equivocal infiltration of the hypodermis (can be seen in atrophic and plaque-like variants of DFSP). The pleomorphic cells can be seen in both entities as DFSP can have areas simulating giant cell fibroblastoma (here we dont see floret cells in the pseudovascular spaces. Agree with Vincenzo, I incline more to cellular Dermatofibroma with monster cells. Just as a last comment watching this case made me remember of this one (dont know if you agree) that Dr. Sundram presented not a long time ago, cells in that case look a little bit more epithelioid but It still amazes me the morphology an epithelioid sarcoma can adopt.

I think there is too much atypia for DFSP. I go with dermatofibroma with monster cells.

this is such a great web site where even an old pathologist like me feel young and strong and continues learning more and more...thanks to all!!!