Patient eventually underwent core needle biopsy:
Surgical pathology
Microscopic
Sections of the biopsy material show a hypercellular spindle cell lesion growing in short fascicles with a predominant storiform pattern that appears to be infiltrating through subcutaneous fat. The cells appear cytologically bland and no mitoses or necrosis is observed. A panel of immunohistochemical stains (single antibody procedure with appropriate controls) were performed to better characterize lesion. They show the tumor cells to be positive for CD34 and negative for pancytokeratin (AE1/AE3) and desmin. There is no nuclear staining for beta-catenin. An S-100 stain highlights rare scattered positive cells. In aggregate, the morphologic and immunophenotypic profile is most consistent with a dermatofibrosarcoma protuberans (DFSP).
Impression
Soft tissue, left chest wall, core needle biopsy
- Dermatofibrosarcoma protuberans (DFSP)