Epithelioid Sarcoma with Psammoma Body Formation: Report of an Autopsy Case and Review of the Literature

概要

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A 62-year-old man complained of a growing superficial nodule in his right palm at the site of a previous injury. This granulomatous nodule was enucleated and histopathological and immunohistochemical examinations led to the diagnosis of epithelioid sarcoma. The patient died about one week after admission due to severe liver dysfunction. Autopsy findings revealed multiple metastatic foci in many organs including lung, liver, and skin. Conventional histopathology of the lung tumors showed a distinct cytological pattern of spindle and polygonal cells that were partially mixed. Electron micrographs showed immature desmosome-like structures and cleaved nuclei in these tumors, features identical to those of epithelioid sarcoma reported by Fujita et al in 1995, supporting the diagnosis in this case. Interestingly, calcification resulting in psammoma body formation was observed in the polygonal cells of the epithelioid sarcoma in the lung. Although epithelioid sarcoma has a variety of histological patterns, to our knowledge, there are no documented case reports of epithelioid sarcomas with psammoma body formation. In this report, we also reviewed rare cases of psammoma body formation in the literature.
昭和大学・昭和医学会の論文