Inflammatory myxohyaline tumor of distal extremities with virocyte or Reed-Sternberg-like cells: a distinctive lesion with features simulating inflammatory conditions, Hodgkin's disease, and various sarcomas.

摘要: We report 51 cases of a previously undescribed tumor the distal extremities that is often mistaken for an inflammatory or infectious process, Hodgkin's disease, various sarcomas. These lesions developed in patients all ages (range, 4-81 yr; median, 40 yr) and affected sexes nearly equally (27 men, 24 women). They presented as painless mass fingers (14 cases), hand (11 wrist arm (10 toe foot (8 lower leg (5 usually within subcutaneous tissues. Grossly, they were infiltrative, multinodular masses characterized by dense chronic infiltrate merged with stroma, which varied from densely hyaline to focally myxoid contained sheets short spindled rounded epithelioid cells. Focally, cells extremely large bizarre, vesicular nuclei macronucleoli resembling Reed-Sternberg virocytes. Despite level atypia, mitotic activity was low. The consistently expressed vimentin but lacked variety other mesenchymal, epithelial markers, e.g., S100 protein, desmin, actin, neuron-specific endolase, membrane antigen, HMB-45, CD34) leukocyte markers (CD15, CD30, CD45). Keratin noted weakly four CD68 six cases, latter suggesting had acquired phagocytic properties. Immunostains cytomegalovirus negative. Polymerase chain reaction Epstein-Barr virus showed amplification levels consistent latent infection 4 10 no active infection. All bacterial viral cultures Follow-up information available 27 cases. Recurrences (interval, 15 mo-10 yr), there metastases tumor-related deaths. In one patient, progressive proximal extension up noted. Although most common submitting diagnosis negative studies agents, clinical behavior local recurrences, immunophenotypic profile, cytologic atypia support idea these are unusual mesenchymal neoplasms at least potential recurrence. It remains be investigated whether time will prove have metastatic potential.