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Off-Center Fold
May 2009

Giant Fleshy Mass Over the Left Axilla—Diagnosis

Author Affiliations
 

MICHAEL E.MINGMD, MSCE

 

CARRIE ANN R.CUSACKMDSENAIT W.DYSONMDJACQUELINE M.JUNKINS-HOPKINSMDVINCENTLIUMDKARLA S.ROSENMANMD

Arch Dermatol. 2009;145(5):589-594. doi:10.1001/archdermatol.2009.89-b

Histologic examination revealed a dermal nodular biphasic proliferation composed of pleomorphic epithelioid cells with irregular hyperchromatic nuclei, prominent nucleoli, abundant eosinophilic cytoplasm, and plump spindle cells. The cells dissected between the collagen bundles and focally formed a pseudogranulomatous pattern around relatively acellular zones of degenerated connective tissue (Figure 3). Mitotic figures were occasionally noted (Figure 4). Immunohistochemical analysis revealed the proliferation to be positive for vimentin, pancytokeratin, and smooth muscle actin and negative for S100, HMB45, and CD31 stains. In addition, the epithelioid component exhibited strong reactivity with epithelial membrane antigen. These findings are characteristic of ES.

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