Two cases of atypical decubital fibroplasia (ischemic fasciitis) were presented. Both patients were immunocompromized and their lesions were located in usual decubital places (back shoulder, femorogluteal region). Histology was typical: 1. zone of fibrinoid necrosis, 2. neighbouring cellular parts reminding of proliferative fasciitis. Focal high cellularity with atypical ganglioid fibroblasts and mitotic activity imitated sarcoma. Immunohistochemistry showed expression of vimentin in all cells and of KP1 (CD 68), lysozym as well as F-XIIIa in majority of them. There was not any expression of desmin, actin, S-100 protein, cytokeratin and epithelial membrane antigen. Importance of atypical decubital fibroplasia (ischemic fasciitis) is in its histological similarity to sarcoma-as it was in both the presented cases.
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Decubital ischemic fasciitis, also called atypical decubital fibroplasia, is a distinctive fibroplasia occurring in nonambulatory older patients who are confined to bed or wheelchair-bound. These lesions are seen in the subcutaneous plane at pressure points or bony prominences. We present a case of ischemic fasciitis in a 68-year-old male patient who presented with a hard swelling in the middle third of the posterolateral aspect of the right leg, which is an unusual site for ischemic fasciitis.
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