A Case of Atypical Cutaneous Fibrous Histiocytoma

Atypical cutaneous fibrous histiocytoma (ACFH) is not well known and only a small number of cases have been reported. Characteristically, ACFH is found on the trunk and limbs of middle-aged women. Although considerable cellular atypia may be present, it occurs focally, the remainder of the tumor representing more classical cutaneous fibrous histiocytoma. A 37-year-old woman presented with a solitary brownish firm nodule on her right forearm. No other abnormalities were found in her personal or family history. Clinically, the tumor simulated a benign fibrous histiocytoma. Histologic examination revealed a poorly delineated intradermal tumor with the usual appearance of benign cutaneous fibrous histiocytoma, but a variable pro-portion of cells in the tumor were scattered atypical cells or bizarre multinucleated giant cells. We report upon a rare case of ACFH.

A Case of Cutaneous Abscess Due to Scedosporium apiospermum / 대한피부과학회지

Scedosporium apiospermum is the asexual stage of Pseudallescheria boydii that is ubiquitous in nature. The localized cutaneous abscess due to S. apiospermum is rare and it is usually originated from the traumatic inoculation of fungal elements. We report a case of cutaneous abscess caused by S. apiospermum. A 67-year-old woman presented with one-year history of subcutaneous nodules on the left forearm, which had been misdiagnosed as cutaneous tuberculosis. Cultural isolation for definitive diagnosis showed typical S. apiospermum.

A Case of Acute Myelocytic Leukemia developed the Cutaneous Granulocytic Sarcoma (Chloroma) and Leukemia Cutis / 대한피부과학회지

Cutaneous granulocytic sarcoma are rare extramedullary tumor composed of immature leukemic cells of the myeloid series. It has a characteristic greenish color caused by myeloperoxidase in the granulocytic cells. 58-year-old female patient who had been diagnosed as acute myelocytic leukemia presented multiple, variable sized, tender brown-pigmented nodules, papules and plaques on the abdomen and both upper extremities for about 4 weeks. An incision biopsy of the large subcutaneous nodule on her abdomen showed a dense dermal infiltrate of immature myeloblastic cells with pleomorphic hyperchromatic vesicular nuclei and conspicuous nucleoli. A punch biopsy of the other small papule on her abdomen showed an infiltrate of granulocytic cells with round hyperchromic nuclei and granular acidophilic cytoplasm, between the dermal collagen bundles. We present a case of the cutaneous granulocytic sarcoma (chloroma) with coexistent leukemia cutis in acute myelocytic leukemia developed from myelodysplastic syndrome.

A Case of Acute Myelocytic Leukemia developed the Cutaneous Granulocytic Sarcoma (Chloroma) and Leukemia Cutis / 대한피부과학회지

Cutaneous granulocytic sarcoma are rare extramedullary tumor composed of immature leukemic cells of the myeloid series. It has a characteristic greenish color caused by myeloperoxidase in the granulocytic cells. 58-year-old female patient who had been diagnosed as acute myelocytic leukemia presented multiple, variable sized, tender brown-pigmented nodules, papules and plaques on the abdomen and both upper extremities for about 4 weeks. An incision biopsy of the large subcutaneous nodule on her abdomen showed a dense dermal infiltrate of immature myeloblastic cells with pleomorphic hyperchromatic vesicular nuclei and conspicuous nucleoli. A punch biopsy of the other small papule on her abdomen showed an infiltrate of granulocytic cells with round hyperchromic nuclei and granular acidophilic cytoplasm, between the dermal collagen bundles. We present a case of the cutaneous granulocytic sarcoma (chloroma) with coexistent leukemia cutis in acute myelocytic leukemia developed from myelodysplastic syndrome.

Clinical and Pathologic Findings of Dysplastic Nevus: Review of 15 Cases / 대한피부과학회지

BACKGROUND: The dysplastic nevus is a rare form of melanocytic nevus, but the clinical criteria and histopathologic finding are still debated. There are no studies of dysplastic nevus in korea except a few case reports. OBJECTIVE: This study was aimed to evaluate the clinical and histopathological characteristics of dysplastic nevus developed in korean. METHODS: We reviewed the clinical and histopathologic finding of 15 patients diagnosed as dysplastic nevus on the biopsy. RESULTS: The result were as follows ; 1. The incidence of dysplastic nevus in our study was 9.9 cases/100,000 population 2. The subjects consisted of 9 males and 6 females. 3. The common onset of age was 11-20. 4. The common site of dysplastic nevus was the trunk. 5. The common pattern of lesional change was asymmetry and color variegation. 6. The common clinical findings of the dysplastic nevus was multiple, 5-12mm size, multipapular surface, ill-demarcated margin and brown/black color. 7. The pathologic findings including shoulder phenomenon, melanocytic nest, patchy lymphohistiocytic infiltration, melanophage, scattered atypical epitheloid cell, random atypia, anisokaryosis and no mitosis was shown in all the patients, but eosinophilic hyperplasia was shown in 13 patients. 8. The mild atypia in the Duke grading system was the most common. There was significant positive correlation between architectural and cytologic scores(Pearson correlation test, P<0.05, r=0.97). CONCLUSION: Although the incidence of the dysplastic nevus in our study was much lower than that of the west, the clinicopathologic findings were not different.

A Case of Neuroendocrine Carcinoma / 대한피부과학회지

Neuroendocrine neoplasms have been described in virtually every organ where neuroendocrine cells are distributed throughout the body. It commonly exhibits multiple lines of divergent differentiation. We report a case of neuroendocrine carcinoma occurring in a 52-year-old woman. She had multiple subcutaneous nodules on the trunk. The light microscopic appearance and immunohistochemical stains were consistent with a neuroendocrine carcinoma. But it showed some differences from Merkel cell carcinoma in clinical and immunohistochemical findings. It may be strongly suggested that it was probably metastatic neuroendocrine carcinoma.

Cutaneous Abscess Caused by Paecilomyces lilacinus in a Renal Transplant Patient / 대한의진균학회지

Paecilomyces lilacinus is an ubiquitous saprophytic fungus and very rarely pathogenic to the human. Although it has been reported to cause endophthalmitis, orbital cellulitis, prosthetic valve endocarditis, and pulmonary infection, cutaneous infection caused by Paecilomyces lilacinus has been rarely reported. A 46-year-old Korean man had asymptomatic slowly growing multiple cutaneous nodules on the left arm and wrist for 8 months. He received a renal transplantation in 1991 because of end-stage renal disease. Postoperatively, he has taken cyclosporin and deflazacort for immunosuppression. Physical examination revealed that the lesions were discrete or confluent, firm, elevated, well-defined fluctuating nodules. Histologic section showed multiple well-encapsulated intradermal abscesses with some foci of chronic granulomatous changes composed of lymphocytes, histiocytes and giant cells. PAS positive fungal hyphae and spores were also found. On the Sabouraud's dextrose agar media, the organism grew rapidly to form velvety lilac-colored colonies with shallow radiating furrows. Slide culture showed brush-like conidiophores ending in flask-shaped phialides carrying chain of conidia. Because of the poor response to the oral antifungal drug for 2 months, all the lesions were completely excised.