Dermatopathology

Superficial Angiomyxoma

Cutaneous myxomas do not metastasize but can recur and while typically sporadic can be associated with Carney's complex.

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Slide 1: 60 year-old man with a smooth papule of the left knee, R/O dermatofibroma. <br><br>Low power examination reveals striking distortion of the dermis by abundant mucin. The lesion is non-encapsulated and demonstrates a multilobulated growth pattern.
Slide 2: This mucinous nodular distortion of the dermis is accompanied by a proliferation of spindled cells.
Slide 3: These cells appear quite bland. The nuclei are round to oval; nucleoli are barely discernible. The cytoplasms are eosinophilic and fibrillar in quality. There is no significant cellular atypia.
Slide 4: A few blood vessels course through the lesion. The differential diagnosis of this lesion is primarily between focal cutaneous mucinosis and a cutaneous myxoma/superficial angiomyxoma. The latter diagnosis is favored given the multilobulated nature of the lesion and the extent of CD34 positivity (NEXT IMAGE) amid the spindled cells found within this lesion.
Slide 5: The spindled cells are CD34+. DIAGNOSIS: BENIGN CD34+ MYXOMATOUS LESION AS SEEN WITHIN THE SPECTRUM OF A CUTANEOUS SUPERFICIAL ANGIOMYXOMA/MYXOMA.
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