title: CD34-positive superficial myxofibrosarcoma: a potential diagnostic pitfall.
abstract: BACKGROUND
  Myxofibrosarcoma (MFS) arises most commonly in the proximal extremities of the elderly, where it may involve subcutaneous and dermal tissues and masquerade as benign entities in limited biopsy samples. We encountered such a case, in which positivity for CD34 and morphologic features were initially wrongly interpreted as a 'low-fat/fat-free' spindle cell/pleomorphic lipoma. Case series have not assessed prevalence of CD34 reactivity among cutaneous examples of MFS.
  
  
  METHODS
  We performed a systematic review of our institution's experience, selecting from among unequivocal MFS resection specimens those superficial cases in which a limited biopsy sample might prove difficult to interpret. These cases were immunostained for CD34 and tabulated for clinicopathologic characteristics.
  
  
  RESULTS
  After review of all MFS diagnoses over 5 years (n = 56), we identified a study group of superficial MFS for comparison to the index case (total n = 8). Of these, the index and three additional cases (4 of 8, 50%; 2 low, 2 high grade) demonstrated positive staining for CD34, with diffuse staining of spindled cells including cellular processes. Four additional cases showed no or equivocal/rare staining.
  
  
  CONCLUSIONS
  CD34 positivity should be recognized as prevalent among such cases and should not be inappropriately construed as inveighing against a diagnosis of MFS in favor of benign entities.
authors.affiliation: Department of Pathology, University of Michigan, Ann Arbor, MI 48109-0602, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Smith
authors.forename: Ann A
authors.initials: AA
authors.lastname: Poznanski
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Fullen
authors.forename: Linglei
authors.initials: L
authors.lastname: Ma
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: McHugh
authors.forename: David R
authors.initials: DR
authors.lastname: Lucas
authors.forename: Rajiv M
authors.initials: RM
authors.lastname: Patel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34; D003937:Diagnosis, Differential; D005260:Female; D005350:Fibroma / Q000473:pathology*; D005354:Fibrosarcoma / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*
chemical_list: D018952:Antigens, CD34