Solitary subcutaneous mucinosis surrounded by bizarre-shaped, factor XIIIa-positive cells with intranuclear vacuoles.
We describe a subcutaneous mucinosis developing in the right cheek of a 38-year-old man. Histologic examination revealed bipolar fibroblast-like cells embedded in a well demarcated mucinous stroma in the subcutis without a manifest reticulin network. In addition, bizarre, sometimes multinucleate, cells with intranuclear vacuoles were found at the periphery of the mucinous stroma. Immunohistologically, both the bipolar fibroblastic cells and bizarre-shaped cells were positive for vimentin, but were negative for smooth muscle A-actin, desmin, CD34, S100, trypsin, or chymotrypsin. However, the latter reacted to anti-factor XIIIa antibody, suggesting that they are derived from dermal dendritic cells. We think that this solitary subcutaneous mucinosis is a unique variant of cutaneous focal mucinosis, because neither a reticulin network nor reactivity to anti-smooth muscle A-actin antibody were demonstrable.
Department of Dermatology, Tohoku University School of Medicine, Sendai, Japan. terui@mail.cc.tohoku.ac.jp
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D000328:Adult; D002467:Cell Nucleus / Q000473:pathology; D002610:Cheek / Q000473:pathology; D003937:Diagnosis, Differential; D005347:Fibroblasts / Q000378:metabolism / Q000473:pathology; D015726:Giant Cells / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D017520:Mucinoses / Q000378:metabolism / Q000473:pathology*; D009077:Mucins / Q000378:metabolism; D009232:Myxoma / Q000175:diagnosis; D012871:Skin Diseases / Q000378:metabolism / Q000473:pathology*; D011503:Transglutaminases / Q000378:metabolism*; D014617:Vacuoles / Q000473:pathology; D014746:Vimentin / Q000378:metabolism
D009077:Mucins; D014746:Vimentin; D011503:Transglutaminases