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Epithelioid Cell Histiocytoma: A Simulant of Vascular and Melanocytic Neoplasms

Glusac, Earl J. M.D.; McNiff, Jennifer Madison M.D.

The American Journal of Dermatopathology: February 1999 - Volume 21 - Issue 1 - p 1-7

Epithelioid cell histiocytoma (ECH) is an unusual and still poorly recognized variant of benign fibrous histiocytoma. Epithelioid cell histiocytoma differs from most benign fibrous histiocytomas in five important ways: the predominance of epithelioid cells, relative lack of secondary elements (such as giant cells, foamy, or hemosiderin-laden macrophages), relative sharp circumscription, prominent vascularity, and centering in the papillary dermis in most cases. A strong resemblance to melanocytic and vascular lesions has been noted, and a recent case was reported with features suggesting endothelial origin. Fifteen new cases of ECH, including one example of the rare deep cellular variant, are presented herein, with emphasis on features mimicking vascular and melanocytic neoplasms. Labeling with endothelial markers, including previously unreported CD-31 labeling, showed abundant vascular staining, which may be challenging to interpret, but which does not indicate an endothelial origin of ECH.

From Yale University School of Medicine, Departments of Pathology and Dermatology, New Haven, Connecticut, U.S.A.

Address correspondence to Earl J. Glusac, M.D., Yale University School of Medicine, Dermatopathology Laboratory, P.O. Box 208059, New Haven, CT 06520-8059.

© 1999 Lippincott Williams & Wilkins, Inc.