Annals of Tropical Medicine and Public Health

LETTER TO THE EDITOR
Year
: 2017  |  Volume : 10  |  Issue : 1  |  Page : 261--263

Myopericytom


Sunil Y Swami, Harshiya Gupta, Grace D'Costa 
 Department of Pathology, SRTR Government Medical College, Ambajogai, Maharashtra, India

Correspondence Address:
Dr. Sunil Y Swami
Bhagwanbaba Chowk, Gitta - Road, Shepwadi. Taluka: Ambajogai, Beed, Ambajogai, Maharashtra
India




How to cite this article:
Swami SY, Gupta H, D'Costa G. Myopericytom.Ann Trop Med Public Health 2017;10:261-263


How to cite this URL:
Swami SY, Gupta H, D'Costa G. Myopericytom. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Oct 24 ];10:261-263
Available from: http://www.atmph.org/text.asp?2017/10/1/261/205556


Full Text

Sir/Madam,

The term “myopericytoma” (MPC) was endorsed by the World Health Organisation (WHO) in 2002.[1] MPC presents as a benign, slow-growing nodule, and may occasionally be painful.[2] There is a predilection for lesions to involve the distal extremities; however, tumors can, in addition, arise at other sites, including the proximal extremities and the neck.[1],[3]

 Case Report



An 80-year-old female, presented with a painful swelling over the left palm since 1.5 years. There was no history of trauma. On gross examination, a single tiny tissue bit was received of size 0.5 cm × 0.5 cm × 0.5 cm, firm in consistency, and greyish-white in colour. Histopathology [Figure 1] and [Figure 2] revealed well-circumscribed tumor tissue composed of plenty of vascular channels lined by concentrically arranged myoid cells that blend with the surrounding stroma as well. Stroma was scanty with sparse chronic inflammatory cells.{Figure 1}{Figure 2}

Immunoprofile showed actin positivity [Figure 3], focal CD34 positivity [Figure 4], and desmin negativity [Figure 5] in the tumor tissue.{Figure 3}{Figure 4}{Figure 5}

After correlating the immunohistochemical pattern with the histopathologic features of the lesion, a final diagnosis of MPC was established.

 Discussion



MPCs are unusual groups of superficial lesions with prominent vessels surrounded by concentrically arranged myoid cells that blend with similar stromal cells. These lesions appear to be the hybrid between hemangiopericytomas (HPC) and angiomyomas (AM), but unlike HPC, they express both actin and desmin.[4] AM usually lacks the characteristic perivascular growth of neoplastic cells typically seen in MPC. Immunohistochemically, most tumor cells of AM and MPC are positive for smooth muscle actin (SMA). Desmin is diffusely positive in AM, whereas most MPCs are negative for desmin.[1],[3],[5]

Application of strict morphological criteria and appropriately selective immunohistochemical markers will help in distinguishing MPC from its mimics.

Immunohistochemically, the tumour cells express positive reactivity for alpha-SMA (α-SMA),[5] muscle-specific actin,[5],[6] and vimentin,[7] and are negative for desmin [5] and CD34.[7]

MPCs are almost always benign. Most do not recur following excision; those that do are likely to be poorly marginated. Rare examples of malignant MPC have been reported.[3],[8]

It is possible that cytogenetic and/or molecular genetic studies may suggest methods for classifying these types of lesions in the future.[5]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1McMenamin ME. Myopericytoma. In: Fletcher CD, Unni KK, Mertens F, editors. WHO Classification of Tumors: Tumors of Soft Tissue and Bone. Lyon, France: IARC Press; 2002.
2Numata I, Nakagawa S, Hasegawa S, Aiba S. A myopericytoma of the nose. Acta Derm Venereol 2010;90:192-3.
3Mentzel T, Dei Tos AP, Sapi Z, Kutzner H. Myopericytoma of skin and soft tissues: Clinicopathologic and immunohistochemical study of 54 cases. Am J Surg Pathol 2006;30:104-13.
4Enzinger and Weiss's. Perivascular tumors. In: Schmitt W, editor. Soft Tissue Tumors. 4th ed. St Louis: Missouri Mosby; 2001. p. 1019.
5Matsuyama A, Hisaoka M, Hashimoto H. Angioleiomyoma: A clinicopathologic and immunohistochemical reappraisal with special reference to the correlation with myopericytoma. Hum Pathol 2007;38:645-51.
6Sadahira C, Yoneda K, Moriue T, Takai I, Kushida Y, Haba R, et al. Periungual myopericytoma. J Am Acad Dermatol 2006;54:1107-8.
7Dray MS, McCarthy SW, Palmer AA, Bonar SF, Stalley PD, Marjoniemi V, et al. Myopericytoma: A unifying term for a spectrum of tumors that show overlapping features with myofibroma. A review of 14 cases. J Clin Pathol 2006;59:67-73.
8McMenamin ME, Fletcher CD. Malignant myopericytoma: Expanding the spectrum of tumours with myopericytic differentiation. Histopathology 2002;41:450-60.