Pleomorphic spindle cell dermal neoplasm with dot-like keratin reactivity: Keratin-positive AFX or carcinoma?

Ransom Ellis, Elizabeth Chase, Alycia Barland, Anand Rajpara, Garth R. Fraga

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Atypical fibroxanthoma (AFX) is an uncommon cutaneous neoplasm of pleomorphic myofibroblast-like cells. Diagnosis requires exclusion of other undifferentiated spindle and pleomorphic cell neoplasms by immunohistochemistry. We report two patients with p63-non-reactive spindle cell neoplasms which resembled AFX but demonstrated anomalous dot-like immunolabeling with antibodies to high molecular weight keratin and keratin 5. One case recurred locally, suggesting such lesions may behave aggressively. Whether these lesions represent keratin-positive dermal sarcomas or poorly differentiated carcinomas is debatable. Regardless of exact classification, our experience suggests such cases should be managed as high-risk non-melanoma skin cancers.

Original languageEnglish (US)
Pages (from-to)847-852
Number of pages6
JournalJournal of Cutaneous Pathology
Volume42
Issue number11
DOIs
StatePublished - Nov 1 2015

Keywords

  • atypical fibroxanthoma
  • dot-like keratin
  • immunohistochemistry
  • squamous cell carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Dermatology

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