title: Clear Cell Atypical Fibroxanthoma: Clinicopathological Study of 6 Cases and Review of the Literature With Special Emphasis on the Differential Diagnosis.
abstract: Atypical fibroxanthoma (AFX) is an uncommon dermal-based neoplasm arising on the sun-damaged skin of elderly people. Clear cell AFX is a rare variant with only 12 cases reported until the present date, all of them as case reports, except for 1 small series of 3 cases. The authors report 6 new cases and review the literature with special emphasis on the differential diagnosis. The clear cell variant represents 5% of AFX from their files. Histopathologically, it consists of sheets of epithelioid, pleomorphic cells, intermixed with a varying number of giant multinucleated and spindle cells, the latter arranged in a fascicular pattern. All cell types predominantly exhibit a clear, microvacuolated cytoplasm with well-demarcated cell borders. The clinical and immunohistochemical features of this variant are similar to those of the classic type. Clear cell AFX must be differentiated from other cutaneous clear cell neoplasms, some of them with an aggressive clinical behavior, including clear cell melanoma, primary cutaneous and metastatic clear cell carcinomas, clear cell sarcoma, pleomorphic liposarcoma, tumor of perivascular epithelioid cells, and distinctive dermal clear cell mesenchymal neoplasm. The clinical presentation and immunohistochemical profile play a key role in the differential diagnosis.
authors: *Department of Pathology, Hospital Universitario de Fuenlabrada, Madrid, Spain; †Department of Pathology, Hospital Universitario Fundación Alcorcón, Madrid, Spain; ‡Department of Pathology, Hospital Universitario de Getafe, Madrid, Spain; §Department of Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain; ¶Department of Dermatology, Hospital Universitario de Fuenlabrada, Madrid, Spain; ‖Department of Pathology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; **Department of Pathology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; and ††Department of Pathology, Hospital Universitario Infanta Sofía de San Sebastián de los Reyes, Madrid, Spain.
authors: Juan C
authors: JC
authors: Tardío
authors: Fernando
authors: F
authors: Pinedo
authors: José Antonio
authors: JA
authors: Aramburu
authors: Miguel Á
authors: MÁ
authors: Martínez-González
authors: Dolores
authors: D
authors: Arias
authors: Radia
authors: R
authors: Khedaoui
authors: Dolores
authors: D
authors: Suárez-Massa
authors: Carlos
authors: C
authors: Santonja
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006258:Head and Neck Neoplasms / Q000737:chemistry / Q000145:classification / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012535:Scalp / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D012878:Skin Neoplasms / Q000737:chemistry / Q000145:classification / Q000473:pathology* / Q000601:surgery; D013030:Spain
chemical_list: D014408:Biomarkers, Tumor