chapter 8, tier 2, textual level
Note: The following legends have no relationship to any of the photomicrographs at tier 3. They did pertain to original B & W prints that are no longer available. These are legends for the original photomicrographs which accompanied the original [rejected] manuscript. I have chosen not to delete these legends; in part, the legends supplement the description of histopathologic findings of the original manuscript.
1. This sessile, polypoid lesions abuts upon the epidermis. It is variably cellular and focally myxomatous. It is expansile and at its interface with the dermis, is outlined in part by condensed fibrous tissue.
2. The configuration of this lesion is similar to that seen in figure 1. The lesion is richly vascular. In the deep myxoid portion, the vessels are thin and compressed. Vessels with these characteristics are immunoreactive for smooth muscle actin. The vessels in the superficial, cellular component are rounded in outline and dilated.
3. This lesion is uniformly cellular. It is separated from the epidermis by a thin grenz zone. Dilated vessels are variably in distribution. Although the nature of the basic cell type in "epithelioid histiocytoma" remains uncertain by light microscopy and immunohistochemistry, histiocytic qualities and epithelioid cellular aggregates are implicit in the designation. n.
4. Native cells are both spindle shaped and rounded in outline. They are loosely spaced in a delicate fibromyxomatous matrix. The vessels are variable in distribution, caliber, and outline. In general, the vessels are not configured in the patterns of hemangiopericytoma of soft tissue.
5. The native tumor cells are complexly dendritic. The thin walled vessels as represented in this field are of the type associated with pericytes that are immunoreactive for smooth muscle actin.
6. In this field, thick-walled vessels are clustered. Rounded, tumor cells are isolated in the fibrous walls of the vessels. Vessels of this type were not associated with pericytes that were immunoreactive for smooth muscle actin.
7. In this field, the cells are supported by a delicate, fibromyxomatous matrix. The lesion is basically myxomatous. Some of the tumor cells are arranged in whorls around vessels.
8. In this field, the cells are supported by delicate, rather homogeneous fibrous matrix. Distinctive vessels of a type that are not associated with smooth muscle actin (+) pericytes are numerous and closely spaced.
9. In this field, the lesion is fibrous. There are ill-defined fascicles and occasional starburst-like patterns. Many of the stroma whorls are representative of the relationships between vessels and neighboring tumor cells.
10. This large, cellular example, protrudes into the dermis. It extends as a column into the dermis and beyond the level of neighboring follicles.
In this field, the myxomatous patterns are prominent and some of the perivascular patterns are reminiscent of the patterns of cardiac myxoma.
Adventitial Cellular Myxofibroblastoma
(another lesion rich in dendritic histiocytes)
Donald Pulitzer, M.D.*,
Syed Hoda, M.D.**, and
Richard J. Reed, M.D***
*Greensboro Pathology Associates, P.A., 706 Green Valley Rd., Suite 104, Greensboro, NC., 27408.
**Department of Pathology, the New York Hospital-Cornell Medical Center, 525 East 68th St., New York, New York 10021.
***Reed Consultations, Suite 302, 234 Loyola Ave., New Orleans, La. 70112