CLINICAL HISTORY
Growth of a painless, 3 cm mass at the right hypothenar eminence was noticed over a 3-month period.
LABORATORY DATA
Noncontributory.
ANCILLARY STUDIES
Immunohistochemistry was performed for vimentin (Figure 1), smooth muscle actin (Figure 2), pancytokeratin, S100, HMB45 and CD34.
GROSS PATHOLOGY
Nodule of tan/gray, solid, soft tissue with smooth surface measuring 3 cm.
MICROSCOPIC PATHOLOGY
H&E stain showed an encapsulated solid spindle cell lesion with high cellularity and areas of hyaline degeneration. Inflammatory cells were seen around a small hemorrhagic area. No thick-walled vessels were seen. Focally, the lesion extended through the capsule. Areas of densely packed, blunt-ended and bipolar spindle cells with streaming or whorled pattern were appearant. Cytologically, the lesion showed marked pleomorphism and hyperchromatic nuclei with prominent nucleoli. The nuclei were elongated; some of them were blunt-ended, and others were pointed. No mitoses were identified.
|