Case 14
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51 year-old male with mass in right hand
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Prepared by: 
Marille E. Herrmann, MD, PhD
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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.

Figure 1 Figure 2
Figure 1: Figure 2:

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.

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Figure 3 Figure 4 Figure 5
Figure 3: Figure 4: Figure 5:
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CASE PRESENATIONS
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