83 yrs lady with "cutaneous AILT" diagnosed twice in general oncology dept with possibly "surgical way of thinking" (2007 "Ca cutis reg. cruris"-2013 "fibroma reg. cruris"). Local radiation after each episode (wise?) without haematological evaluation (BM absent) and chemo.  
2014: reexcision.  
MACRO: 6,5x3,5x0,5 cm skin piece with irregular induration 4,3x3 cm.  
HISTO: Vaguelly nodular, vascularised, effected by fibrosis (postradio-?) heterogenous infiltrate, enreached by atypical spindle and "histyoid" cells and scant T CD4+ lymphos admiture.  
IH:  
MOLECS:  
2014: B/T polyclonal.  
2007: pending.  
 
Question: definite classification of cutanous elderly LPD vs mesenchymal lesion? Other? (?)(AILT is not there...).

tzankov 2014-10-06 10:13	Dear Ugnius,   can you tell us the exact skin region where the biopsy was taken from?   Did the lesions in 2013 and 2014 re-occurr at the same location as that in 2007?
ugnius 2014-10-06 10:15	Presumably the same (lower leg)...
tzankov 2014-10-06 12:43	I do not think that this is a hemato-lymphoid malignancy. I suppose that we have to reconsider the older diagnoses and exclude/verify fibroblastic/myofibroblastic and fibro-histocytic tumors: CD34? CD99? pSTAT6? EMA? Cytokeratin? probably on the pre-irradiation tissue from 2007...