Case Number : Case 3023 - 7 February 2022 Posted By: Dr. Mona Abdel-Halim

Dermatofibrosarcoma protruberans.  The cytology is rather bland, but the clinical description, depth of penetration and CD34 positivity clinch the diagnosis.

agree for DFSP

Agree with DFSP

Yes. Agree. 

I saw this case on my cpt ( first spot on iPhone ). Not sure about DFSP. The cellular features are more in keeping with DF.  

DFSP?

15 hours ago, vincenzo said:

I saw this case on my cpt ( first spot on iPhone ). Not sure about DFSP. The cellular features are more in keeping with DF.  

I agree, the cytology that we are shown is not very worrying.  However, we can only see the upper part of the tumour.  Very often in DFSP, the deeper part of the tumour shows much more abnormal cellular features.

8 hours ago, Richard Logan said:

I agree, the cytology that we are shown is not very worrying.  However, we can only see the upper part of the tumour.  Very often in DFSP, the deeper part of the tumour shows much more abnormal cellular features.

Agree. However The cells show a clear, maybe foamy cytoplasm, histiocytic-like, more in keeping with DF. CD34 positivity could be a misleading sign. Waiting for final comments. 

15 hours ago, vincenzo said:

Agree. However The cells show a clear, maybe foamy cytoplasm, histiocytic-like, more in keeping with DF. CD34 positivity could be a misleading sign. Waiting for final comments. 

I am pushed to a diagnosis of DFSP by the characteristic and paradoxical combination of atrophy and nodularity.  I wouldn’t expect those in a dermatofibroma.

This biopsy was diagnosed as DFSP. Clinically, it was a large plaque with atrophic areas and several protuberant nodular areas, typical of DFSP. Patient was referred for WLE.