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A case of pseudomyogenic hemangioendothelioma of the back misdiagnosed as epithelioid sarcoma
( Ji Youn Hong ),( Ji Su Lee ),( Sung Min Kim ),( Jin Hee Kim ),( Joo Ran Hong ),( Hye In Cheon ),( Min Seok Hur ),( Yang Won Lee ),( Yong Beom Choe ),( Kyu Joong Ahn ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
A 25-year-old man referred to our dermatologic clinic with one month history of multiple nodular lesions on the back, histopathologically reported epithelioid sarcoma. A punch biopsy was performed again at our clinic, which demonstrated atypical spindle cell proliferative lesion. The tumor cells were immunoreactive for CD31, ERG, Multi-Cytokeratin (CK), INI-1, and vimentin, and were negative for S-100, SMA, EMA, and CD68. Ki-67 index was about 10% of tumor cells. Based on these results, this case is finally diagnosed as pseudomyogenic hemangioendothelioma (PHE). The patient was referred to plastic surgery department and treated with wide local excision. PHE is a rare soft tissue tumor, frequently presenting as multiple nodular lesions in the lower extremities. PHE is also known as epithelioid sarcoma-like hemangioendothelioma, which means that PHE can histopathologically mimic epithelioid sarcoma. In comparison with epithelioid sarcoma, PHE is a relatively indolent and rarely metastasizing tumor. Therefore, a definite diagnosis is important because treatment and prognosis are remarkably different. Immunochemistry is important for differential diagnosis. We herein report the case of PHE diagnosed by immunochemistry, which was misdiagnosed as an epithelioid sarcoma.