Solitary sclerotic fibroma of skin: a possible link with pleomorphic fibroma with immunophenotypic expression for O13 (CD99) and CD34.
BACKGROUND
Solitary sclerotic fibroma (SF) presents as a well circumscribed dermal nodule, composed of sparse spindle cells with alternating wavy collagen fibers arranged in a storiform pattern. The histogenesis and nature of this histologically distinct lesion are uncertain. Whether this peculiar tumor represents a true hamartoma or a degenerating end of various fibrous lesions such as pleomorphic fibroma (PF), dermatofibroma, or angiofibroma is still controversial. High proliferating index of spindle cells in SF argues against the possibility of being a degenerating end product of another lesion.


METHODS
We studied morphological features and immunoprofile of eight SFs, in comparison with four PFs, one collagenized dermatofibroma, two angiofibromas, and two periungual fibromas. Immunostains for CD34, CD31, O13 (CD99), Factor XIIIa, S-100, CD68 (KP-1), and MIB-1 were carried out using a labeled streptavidin-biotin method with DAKO-automated immunostainer. Paraffin blocks of two SFs were reprocessed for electron microscopic studies. Clinical data of all patients with SF were also reviewed.


RESULTS
Spindle cells and pleomorphic cells in SF and PF showed diffuse immunoreactivity for CD34 and O13 but were negative for CD31, S-100, and CD68. Spindle cells in one dermatofibroma and one angiofibroma were positive for Factor XIIIa. Proliferating index (MIB-1) was very low in all cases of SF, contradicting some previous reports.


CONCLUSIONS
SF is a fibrotic lesion with cells positive for CD34 and O13. It shares a common immunoprofile with PF but is distinct from dermatofibroma and other common spindle cell lesions of skin. O13 expression in SF has not been previously described.
Mahmood
Muhammad N
MN
Department of Pathology, Henry Ford Hospital, Detroit, MI 48202, USA. nosh97@hotmail.com
Salama
Mohamed E
ME
Chaffins
Marsha
M
Ormsby
Adrian H
AH
Ma
Chan K
CK
Linden
Michael D
MD
Lee
Min W
MW
D000071443:12E7 Antigen; D018322:Angiofibroma / Q000276:immunology / Q000473:pathology; D015703:Antigens, CD / Q000032:analysis*; D018952:Antigens, CD34 / Q000032:analysis*; D015815:Cell Adhesion Molecules / Q000032:analysis*; D005350:Fibroma / Q000276:immunology* / Q000473:pathology*; D018219:Histiocytoma, Benign Fibrous / Q000276:immunology / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D016130:Immunophenotyping; D009260:Nail Diseases / Q000276:immunology / Q000473:pathology; D012598:Sclerosis; D012878:Skin Neoplasms / Q000276:immunology* / Q000473:pathology*; D013194:Staining and Labeling
D000071443:12E7 Antigen; D015703:Antigens, CD; D018952:Antigens, CD34; C061828:CD99 protein, human; D015815:Cell Adhesion Molecules