Plexiform fibrohistiocytic tumor is a rare tumor that arises primarily on the upper extremities of children and young adults.[1]: 612
Signs and symptoms
Plexiform fibrohistiocytic tumor appears as a painless, slowly expanding soft tissue mass located in the dermis and subcutis.[2] The skin layer above is somewhat elevated and occasionally has a central depression.[3] The upper extremities were more commonly affected by plexiform fibrohistiocytic tumors. It was most frequently found on the fingers, hand, or wrist.[4] The tumour's dimensions vary from 0.3 to 8.5 cm.[2]
Causes
Plexiform fibrohistiocytic tumor's pathogenesis is unclear.[2] A few cases of prior trauma have been documented.[3] Two series of congenital instances have been documented.[5][6]
Diagnosis
From a histological perspective, plexiform fibrohistiocytic tumor is made up of several tiny nodules or long fascicles that are primarily arranged in a plexiform pattern. Variable amounts of three distinct cell types are found. These are multinucleate large cells, mononuclear histiocyte-like cells, and spindle fibroblast-like cells.[7]
There are three main well-documented histologic patterns that have been identified: a fibrohistiocytic subtype that consists of plexiform clusters of mononuclear histiocyte-like cells and multinucleated giant cells; a fibroblastic subtype that consists primarily of elongated clusters and short fascicles of spindle fibroblast-like cells; and a mixed subtype that consists of equal parts of both patterns.[5][8]
The fibroblastic cells show uniform reactivity to vimentin and at least focal reactivity for smooth muscle actin, while the histiocytic cells of plexiform fibrohistiocytic tumor stain for CD68 (KP-1).[2]
^ abEnzinger, Franz M.; Zhang, Renyuan (1988). "Plexiform Fibrohistiocytic Tumor Presenting in Children and Young Adults". The American Journal of Surgical Pathology. 12 (11). Ovid Technologies (Wolters Kluwer Health): 818–826. doi:10.1097/00000478-198811000-00002. ISSN0147-5185.
^Remstein, Ellen D.; Arndt, Carola A.S.; Nascimento, Antonio G. (1999). "Plexiform Fibrohistiocytic Tumor: Clinicopathologic Analysis of 22 Cases". The American Journal of Surgical Pathology. 23 (6). Ovid Technologies (Wolters Kluwer Health): 662–670. doi:10.1097/00000478-199906000-00005. ISSN0147-5185.
^ abHOLLOWOOD, K.; HOLLEY, M.P.; FLETCHER, C.D.M. (1991). "Plexiform fibrohistiocytic tumour: clinicopathological, immunohistochemical and ultrastructural analysis in favour of a myofibroblastic lesion". Histopathology. 19 (6). Wiley: 503–513. doi:10.1111/j.1365-2559.1991.tb01498.x. ISSN0309-0167.
^Leclerc, Stéphanie; Hamel‐Teillac, Dominique; Oger, Patrice; Brousse, Nicole; Fraitag, Sylvie (2005-08-18). "Plexiform fibrohistiocytic tumor: three unusual cases occurring in infancy". Journal of Cutaneous Pathology. 32 (8). Wiley: 572–576. doi:10.1111/j.0303-6987.2005.00334.x. ISSN0303-6987.
Thangaiah, Judith Jebastin; Dashti, Nooshin K.; Agaimy, Abbas; Fritchie, Karen; Folpe, Andrew L. (2022). "Plexiform fibrohistiocytic tumor: a clinicopathological and immunohistochemical study of 39 tumors, with evidence for a CSF1-producing "null cell" population". Virchows Archiv. 481 (5): 739–750. doi:10.1007/s00428-022-03408-2. ISSN0945-6317.
Chen, Yi-Chun; Hsiao, Cheng-Hsiang; Chen, Jau-Shiuh; Liao, Yi-Hua (2010). "Plexiform fibrohistiocytic tumor—report of one case with regional lymph node metastasis". Dermatologica Sinica. 28 (3). Medknow: 117–120. doi:10.1016/s1027-8117(10)60025-0. ISSN1027-8117.