Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2021; 9(12): 2739-2750
Published online Apr 26, 2021. doi: 10.12998/wjcc.v9.i12.2739
Clinicopathological features of superficial CD34-positive fibroblastic tumor
Li Ding, Wen-Jing Xu, Xiao-Ying Tao, Liang Zhang, Zhao-Gen Cai
Li Ding, Wen-Jing Xu, Zhao-Gen Cai, Department of Pathology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, Anhui Province, China
Xiao-Ying Tao, Department of Pathology, Hangzhou People's Hospital, Hangzhou 310000, Zhejiang Province, China
Liang Zhang, Department of Pathology, Huaiyuan County People's Hospital, Bengbu 233000, Anhui Province, China
Author contributions: Ding L, Xu WJ, and Tao XY collected the data and wrote the paper; Cai ZG analyzed the data and directed the writing; Zhang L checked the article for errors.
Supported by Key Projects of Natural Science Research in Colleges and University of Anhui Province, No. 2017A236.
Institutional review board statement: This study was approved by the Ethics Review Committee of Bengbu Medical College and the First Affiliated Hospital of Bengbu Medical College (2020KY036).
Conflict-of-interest statement: None.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhao-Gen Cai, MD, Professor, Department of Pathology, the First Affiliated Hospital of Bengbu Medical College, No. 287 Changhuai Road, Bengbu 233000, AnHui Province, China. chzgen@163.com
Received: November 11, 2020
Peer-review started: November 11, 2020
First decision: December 31, 2020
Revised: January 13, 2021
Accepted: February 24, 2021
Article in press: February 24, 2021
Published online: April 26, 2021
Processing time: 154 Days and 15.8 Hours
ARTICLE HIGHLIGHTS
Research background

Superficial CD34-positive fibroblastic tumor (SCPFT) is a newly discovered mesenchymal tumor that is mainly composed of fibroblasts. Given the lack of established diagnostic criteria, SCPFT is associated with a high misdiagnosis rate

Research motivation

We are writing this paper to further describe the histopathological characteristics and genetic characteristics of this entity so that pathologists can more accurately diagnose the disease.

Research objectives

The main purpose of this study was to further elucidate the characteristics of SCPFT; its genetic characteristics are of great concern to pathologists.

Research methods

We retrospectively analyzed the clinicopathological, immunohistochemical, and fluorescence in situ hybridization characteristics of four SCPFT patients treated at our institution.

Research results

In general, these tumors are mostly single well-defined nodules. Microscopically, the tumors were composed of irregular spindle to oval-shaped cells with eosinophilic and granular cytoplasm. A few scattered tumor cells were markedly polymorphic with hyperchromatic, abnormal, and pleomorphic nuclei that frequently displayed intranuclear pseudoinclusions. Hematoxylin–eosin staining of some tumors with interstitial mucoid degeneration was similar to that of mucinous fibroblastic sarcoma. Immunohistochemical staining showed that CD34 was strongly expressed in all cases, and approximately 60% of the tumors expressed CK locally (AE1/AE3). ALK and PDGFB gene rearrangements were analyzed in all four cases by fluorescence in situ hybridization. The four tumors were negative for ALK rearrangements, and PDGFB rearrangements were not detected.

Research conclusions

Our findings may further contribute to the recognition of SCPFTs, including the clinical context in which they arise; it is important to avoid confusion with other pleomorphic soft tissue tumors, particularly neoplasms in the group of pleomorphic sarcomas, which are typically aggressive tumors, as that could lead to unnecessary overtreatment.

Research perspectives

In follow-up work, more cases will be collected for comparative studies of the clinical and pathological aspects. An in-depth analysis will be conducted at the genetic level through second-generation sequencing to confirm the uniqueness of this entity and provide the basis for precise clinical treatment.