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Skin - Nonmelanocytic tumors

Other tumors of skin

Histiocytoma


Reviewer: Christopher Hale, M.D. (see Reviewers page)
Revised: 14 September 2012, last major update September 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● Tumor of true histiocytic origin, not fibrohistiocytic
● By definition, excludes Langerhans cell histiocytosis
● Occurs in children; most tumors are benign

Micro description
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● Closely packed histiocytes with eosinophilic cytoplasm and variable lipid droplets, often inflammatory cells
● Minimal stroma
● Older lesions have fibrosis but no active fibroblastic proliferation

Positive stains
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● CD68

Negative stains
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● S100, CD45, CD1a

Electron microscopy description
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● No Birbeck granules


Solitary epithelioid histiocytoma

General
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● Solitary or multifocal tumor, often with articular involvement (Am J Surg Pathol 2006;30:521)
● Formerly called reticulohistiocytoma
● May have malignant behavior

Case reports
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● 39 year old woman with eyelid lesion (Arch Ophthalmol 2011;129:1502)

Micro description
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● Usually upper dermis
● Mononuclear and multinuclear epithelioid histiocytes with eosinophilic to glassy cytoplasm, often with spike-like cytoplasmic extensions
● Nuclei are round/oval with distinct nucleoli and variable nuclear grooves and multinucleation
● Frequent lymphocytes and neutrophils

Micro images
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Dermis contains multinucleated forms


Dermal tumor contains mild atypia, and pushes against epidermis

Giant cell reticulohistiocytoma #1, Giant cell reticulohistiocytoma #2, Giant cell reticulohistiocytoma #3

Positive stains
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● Vimentin, CD163, Factor XIIIa (focal), CD68 (may be focal)

Negative stains
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● S100, keratin, MelanA


Generalized eruptive histiocytoma

General
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● Benign, papular, self-healing histiocytosis characterized by recurrent crops of small, firm, tan to red papules that appear in a symmetrical fashion on the face, trunk and arms, and may regress spontaneously
● Rare, <50 cases described, most in adults
● Part of spectrum of non-Langerhans cell histiocytosis

Case reports
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● 32 year old woman successfully treated with PUVA (J Dtsch Dermatol Ges 2007;5:131)
● 49 year old woman with multiple papules (J Dermatol Case Rep 2011;5:53)

Treatment
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● Local excision - excellent prognosis

Clinical images
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Various images

Micro images
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Various images

Positive stains
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● CD68, MAC387, alpha-1-antichymotrypsin, lysozyme

Negative stains
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● S100, CD1a

Electron microscopy description
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● No Birbeck granules

End of Skin - Nonmelanocytic tumors > Other tumors of skin > Histiocytoma


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