Atypical Fibroxanthoma Differential Diagnoses

  • Author: Forrest C Brown, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jun 2, 2010
 
 

Differential Diagnoses

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Contributor Information and Disclosures
Author

Forrest C Brown, MD  Clinical Professor of Dermatology, University of Texas Southwestern Medical School; Section Chief, Department of Dermatology, Medical City Dallas Hospital

Disclosure: Nothing to disclose.

Specialty Editor Board

Carrie L Kovarik, MD  Assistant Professor of Dermatology, Dermatopathology, and Infectious Diseases, University of Pennsylvania School of Medicine

Carrie L Kovarik, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD  Herman Beerman Associate Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology and American Society of Dermatopathology

Disclosure: Lippincott Williams Wilkins Royalty Textbook editor; DLA Piper Consulting fee Consulting

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Zalla MJ, Randle HW, Brodland DG, et al. Mohs surgery vs wide excision for atypical fibroxanthoma: follow-up. Dermatol Surg. Dec 1997;23(12):1223-4. [Medline].

  2. Ang GC, Roenigk RK, Otley CC, Kim Phillips P, Weaver AL. More than 2 decades of treating atypical fibroxanthoma at mayo clinic: what have we learned from 91 patients?. Dermatol Surg. May 2009;35(5):765-72. [Medline].

  3. Calonje E, Wadden C, Wilson-Jones E, Fletcher CD. Spindle-cell non-pleomorphic atypical fibroxanthoma: analysis of a series and delineation of a distinctive variant. Histopathology. Mar 1993;22(3):247-54. [Medline].

  4. Champion R, Burton JL, Burns DA, Breathnach SM, eds. Rook/Wilkinson/Ebling Textbook of Dermatology. Vol 3. 6th ed. Oxford: Blackwell Science;1998:2352-3.

  5. Diaz-Cascajo C, Borghi S, Bonczkowitz M. Pigmented atypical fibroxanthoma. Histopathology. Dec 1998;33(6):537-41. [Medline].

  6. Fish FS. Soft tissue sarcomas in dermatology. Dermatol Surg. Mar 1996;22(3):268-73. [Medline].

  7. Giuffrida TJ, Kligora CJ, Goldstein GD. Localized cutaneous metastases from an atypical fibroxanthoma. Dermatol Surg. Dec 2004;30(12 Pt 2):1561-4. [Medline].

  8. Grosso M, Lentini M, Carrozza G, Catalano A. Metastatic atypical fibroxanthoma of skin. Pathol Res Pract. Jun 1987;182(3):443-7. [Medline].

  9. Hafner J, Kunzi W, Weinreich T. Malignant fibrous histiocytoma and atypical fibroxanthoma in renal transplant recipients. Dermatology. 1999;198(1):29-32. [Medline].

  10. Lazova R, Moynes R, May D, Scott G. LN-2 (CD74). A marker to distinguish atypical fibroxanthoma from malignant fibrous histiocytoma. Cancer. Jun 1 1997;79(11):2115-24. [Medline].

  11. Lee CS, Chou ST. p53 protein immunoreactivity in fibrohistiocytic tumors of the skin. Pathology. Aug 1998;30(3):272-5. [Medline].

  12. Leong AS, Milios J. Atypical fibroxanthoma of the skin: a clinicopathological and immunohistochemical study and a discussion of its histogenesis. Histopathology. May 1987;11(5):463-75. [Medline].

  13. Ma CK, Zarbo RJ, Gown AM. Immunohistochemical characterization of atypical fibroxanthoma and dermatofibrosarcoma protuberans. Am J Clin Pathol. Apr 1992;97(4):478-83. [Medline].

  14. Michie BA, Reid RP, Fallowfield ME. Aneuploidy in atypical fibroxanthoma: DNA content quantification of 10 cases by image analysis. J Cutan Pathol. Oct 1994;21(5):404-7. [Medline].

  15. Requena L, Sangueza OP, Sanchez Yus E, Furio V. Clear-cell atypical fibroxanthoma: an uncommon histopathologic variant of atypical fibroxanthoma. J Cutan Pathol. Mar 1997;24(3):176-82. [Medline].

  16. Rudisaile SN, Hurt MA, Santa Cruz DJ. Granular cell atypical fibroxanthoma. J Cutan Pathol. Apr 2005;32(4):314-7. [Medline].

  17. Silvis NG, Swanson PE, Manivel JC, et al. Spindle-cell and pleomorphic neoplasms of the skin. A clinicopathologic and immunohistochemical study of 30 cases, with emphasis on "atypical fibroxanthomas". Am J Dermatopathol. Feb 1988;10(1):9-19. [Medline].

  18. Starink TH, Hausman R, Van Delden L, Neering H. Atypical fibroxanthoma of the skin. Presentation of 5 cases and a review of the literature. Br J Dermatol. Aug 1977;97(2):167-77. [Medline].

  19. Wilson PR, Strutton GM, Stewart MR. Atypical fibroxanthoma: two unusual variants. J Cutan Pathol. Apr 1989;16(2):93-8. [Medline].

  20. Worrell JT, Ansari MQ, Ansari SJ, Cockerell CJ. Atypical fibroxanthoma: DNA ploidy analysis of 14 cases with possible histogenetic implications. J Cutan Pathol. Jun 1993;20(3):211-5. [Medline].

  21. Bugatti L, Filosa G. Dermatoscopic features of cutaneous atypical fibroxanthoma: three cases. Clin Exp Dermatol. Dec 2009;34(8):e898-900. [Medline].

 
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Red, beefy, sessile nodule typical of clinical presentation of atypical fibroxanthoma. Note the markedly sun-damaged skin with solar telangiectasias. Courtesy of Capt James Steger, MC, USN, US Naval Hospital, San Diego.
Microscopic view of atypical fibroxanthoma. Note the large abnormal-appearing cells in a field of spindle cells. Courtesy of Capt James Steger, MC, USN, US Naval Hospital, San Diego.
Table. Antibody Panels in Tumors
AntibodyAFXMFHSCCDFSPSpindle



MM*



Leiomyosarcoma
VimentinRRNRRR
CytokeratinNNRNNN
S-100NNNNRN
Desmin or smooth muscle actinNNNNNR
*Spindle cell malignant melanoma
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