Present address: Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
Pleomorphic fibroma and dermal atypical lipomatous tumor: are they related?
Article first published online: 19 MAR 2013
© 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd
Journal of Cutaneous Pathology
Volume 40, Issue 4, pages 379–384, April 2013
How to Cite
Pleomorphic fibroma and dermal atypical lipomatous tumor: are they related?, , , , , , , .
- Issue published online: 19 MAR 2013
- Article first published online: 19 MAR 2013
- Accepted manuscript online: 19 JAN 2013 03:40AM EST
- Manuscript Accepted: 13 JAN 2013
- Manuscript Revised: 6 JAN 2013
- Manuscript Received: 28 JUN 2012
- UT-MD Anderson Physician Scientist Program (AJL)
- dermal atypical lipomatous tumor;
- fluorescence in situ hybridization (FISH);
- pleomorphic fibroma
Pleomorphic fibromas represent dome-shaped or polypoid cutaneous lesions characterized by a paucicellular and densely fibrotic background punctuated by scattered atypical to pleomorphic spindle and multinucleated giant cells. Some of these tumors will have incorporated adipose tissue, although these adipocytic areas lack distinct cytologic atypia and may represent entrapped normal periadnexal or subcutaneous adipose tissue. Nonetheless, owing to the similarity of some of the morphologic features of pleomorphic fibroma with cutaneous atypical lipomatous tumor, diagnostic confusion can ensue. The potential diagnostic challenges are further highlighted by a recent report of a lesion with histopathologic features of both. In response, we studied the presence of 12q15/ MDM2 amplification by fluorescence in situ hybridization and MDM2 expression by immunohistochemistry in a series of 15 pleomorphic fibromas to investigate whether these two entities share a common pathogenic origin. One case of cutaneous atypical lipomatous tumor was used as positive control for 12q15 amplification. All 15 cases were negative for MDM2 by immunohistochemistry with no demonstrable 12q15/MDM2 amplification by fluorescence in situ hybridization. Therefore, these two entities are best regarded as pathogenetically distinct. MDM2 immunohistochemistry or fluorescence in situ hybridization studies can be used to differentiate between the two if needed.