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Collagenous fibroma (desmoplastic fibroblastoma): A clinicopathologic analysis of 63 cases of a distinctive soft tissue lesion with stellate-shaped fibroblasts

Sixty-three cases of collagenous fibroma (desmoplastic fibroblastoma) from the files of the Armed Forces Institute of Pathology were analyzed. These tumors occurred mostly in men (80%) with a median age of 50 years (range, 16 to 81 years). The lesions had a wide anatomic distribution and involved th... Full description

Journal Title: Human pathology 1998, Vol.29 (7), p.676-682
Main Author: Miettinen, Markku
Other Authors: Fetsch, John F
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0046-8177
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title: Collagenous fibroma (desmoplastic fibroblastoma): A clinicopathologic analysis of 63 cases of a distinctive soft tissue lesion with stellate-shaped fibroblasts
format: Article
creator:
  • Miettinen, Markku
  • Fetsch, John F
subjects:
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biological and medical sciences
  • Cytoskeletal Proteins - metabolism
  • Dermatology
  • diagnosis
  • Diagnosis, Differential
  • Female
  • fibroblastoma
  • Fibroblasts - metabolism
  • Fibroblasts - pathology
  • fibroma
  • Fibroma - diagnosis
  • Fibroma, Desmoplastic - metabolism
  • Fibroma, Desmoplastic - pathology
  • Fibrosarcoma - diagnosis
  • Follow-Up Studies
  • Humans
  • Immunoenzyme Techniques
  • immunohistochemistry
  • Magnetic Resonance Imaging
  • Male
  • Medical sciences
  • Middle Aged
  • Sex Distribution
  • soft tissue
  • Soft Tissue Neoplasms - metabolism
  • Soft Tissue Neoplasms - pathology
  • Tumors of the skin and soft tissue. Premalignant lesions
ispartof: Human pathology, 1998, Vol.29 (7), p.676-682
description: Sixty-three cases of collagenous fibroma (desmoplastic fibroblastoma) from the files of the Armed Forces Institute of Pathology were analyzed. These tumors occurred mostly in men (80%) with a median age of 50 years (range, 16 to 81 years). The lesions had a wide anatomic distribution and involved the arm (24%), shoulder girdle (19%), posterior neck or upper back (14%), feet or ankles (14%), leg (14%), hand (8%), and abdominal wall and hip (6%). The patients typically presented with a history of a painless, slowly growing mass, often of relatively long duration. The tumors ranged in size from 1 to 20 cm (median, 3.0 cm). The lesions were predominantly subcutaneous, but fascial involvement was common, and 27% of cases involved skeletal muscle. Gross examination typically showed an elongated, lobulated, or disc-shaped mass with a firm consistency and a homogeneous pearl-gray color. Histologically, the tumors often appeared well marginated on low-power examination, but most (78%) infiltrated fat or, less commonly, skeletal muscle. The lesional cells were relatively bland stellate and spindle-shaped fibroblasts separated by a collag enous or myxocollagenous matrix. Mitotic activity was absent or minimal. Some of the lesional cells had a myofibroblastic immunophenotype, as evidenced by focal reactivity for muscle-specific and a-smooth muscle actins. In a few cases, rare actin-positive cells were also positive for keratins. Desmin, S100 protein, and CD34 were not expressed. None of the 39 patients with follow-up (median, 11 years) developed a recurrence. Collagenous fibroma is a benign fibroblastic/ myofibroblastic proliferation. The large size of some of these tumors coupled with slow growth and persistence favors a neoplastic process over a peculiar reactive proliferation. The differential diagnosis includes a variety of reactive and neoplastic fibroblastic lesions, most importantly fibromatosis and low-grade fibromyxoid sarcoma. Simple, conservative excision is the treatment of choice for collagenous fibroma.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0046-8177
fulltext: fulltext
issn:
  • 0046-8177
  • 1532-8392
url: Link


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titleCollagenous fibroma (desmoplastic fibroblastoma): A clinicopathologic analysis of 63 cases of a distinctive soft tissue lesion with stellate-shaped fibroblasts
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descriptionSixty-three cases of collagenous fibroma (desmoplastic fibroblastoma) from the files of the Armed Forces Institute of Pathology were analyzed. These tumors occurred mostly in men (80%) with a median age of 50 years (range, 16 to 81 years). The lesions had a wide anatomic distribution and involved the arm (24%), shoulder girdle (19%), posterior neck or upper back (14%), feet or ankles (14%), leg (14%), hand (8%), and abdominal wall and hip (6%). The patients typically presented with a history of a painless, slowly growing mass, often of relatively long duration. The tumors ranged in size from 1 to 20 cm (median, 3.0 cm). The lesions were predominantly subcutaneous, but fascial involvement was common, and 27% of cases involved skeletal muscle. Gross examination typically showed an elongated, lobulated, or disc-shaped mass with a firm consistency and a homogeneous pearl-gray color. Histologically, the tumors often appeared well marginated on low-power examination, but most (78%) infiltrated fat or, less commonly, skeletal muscle. The lesional cells were relatively bland stellate and spindle-shaped fibroblasts separated by a collag enous or myxocollagenous matrix. Mitotic activity was absent or minimal. Some of the lesional cells had a myofibroblastic immunophenotype, as evidenced by focal reactivity for muscle-specific and a-smooth muscle actins. In a few cases, rare actin-positive cells were also positive for keratins. Desmin, S100 protein, and CD34 were not expressed. None of the 39 patients with follow-up (median, 11 years) developed a recurrence. Collagenous fibroma is a benign fibroblastic/ myofibroblastic proliferation. The large size of some of these tumors coupled with slow growth and persistence favors a neoplastic process over a peculiar reactive proliferation. The differential diagnosis includes a variety of reactive and neoplastic fibroblastic lesions, most importantly fibromatosis and low-grade fibromyxoid sarcoma. Simple, conservative excision is the treatment of choice for collagenous fibroma.
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descriptionSixty-three cases of collagenous fibroma (desmoplastic fibroblastoma) from the files of the Armed Forces Institute of Pathology were analyzed. These tumors occurred mostly in men (80%) with a median age of 50 years (range, 16 to 81 years). The lesions had a wide anatomic distribution and involved the arm (24%), shoulder girdle (19%), posterior neck or upper back (14%), feet or ankles (14%), leg (14%), hand (8%), and abdominal wall and hip (6%). The patients typically presented with a history of a painless, slowly growing mass, often of relatively long duration. The tumors ranged in size from 1 to 20 cm (median, 3.0 cm). The lesions were predominantly subcutaneous, but fascial involvement was common, and 27% of cases involved skeletal muscle. Gross examination typically showed an elongated, lobulated, or disc-shaped mass with a firm consistency and a homogeneous pearl-gray color. Histologically, the tumors often appeared well marginated on low-power examination, but most (78%) infiltrated fat or, less commonly, skeletal muscle. The lesional cells were relatively bland stellate and spindle-shaped fibroblasts separated by a collag enous or myxocollagenous matrix. Mitotic activity was absent or minimal. Some of the lesional cells had a myofibroblastic immunophenotype, as evidenced by focal reactivity for muscle-specific and a-smooth muscle actins. In a few cases, rare actin-positive cells were also positive for keratins. Desmin, S100 protein, and CD34 were not expressed. None of the 39 patients with follow-up (median, 11 years) developed a recurrence. Collagenous fibroma is a benign fibroblastic/ myofibroblastic proliferation. The large size of some of these tumors coupled with slow growth and persistence favors a neoplastic process over a peculiar reactive proliferation. The differential diagnosis includes a variety of reactive and neoplastic fibroblastic lesions, most importantly fibromatosis and low-grade fibromyxoid sarcoma. Simple, conservative excision is the treatment of choice for collagenous fibroma.
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abstractSixty-three cases of collagenous fibroma (desmoplastic fibroblastoma) from the files of the Armed Forces Institute of Pathology were analyzed. These tumors occurred mostly in men (80%) with a median age of 50 years (range, 16 to 81 years). The lesions had a wide anatomic distribution and involved the arm (24%), shoulder girdle (19%), posterior neck or upper back (14%), feet or ankles (14%), leg (14%), hand (8%), and abdominal wall and hip (6%). The patients typically presented with a history of a painless, slowly growing mass, often of relatively long duration. The tumors ranged in size from 1 to 20 cm (median, 3.0 cm). The lesions were predominantly subcutaneous, but fascial involvement was common, and 27% of cases involved skeletal muscle. Gross examination typically showed an elongated, lobulated, or disc-shaped mass with a firm consistency and a homogeneous pearl-gray color. Histologically, the tumors often appeared well marginated on low-power examination, but most (78%) infiltrated fat or, less commonly, skeletal muscle. The lesional cells were relatively bland stellate and spindle-shaped fibroblasts separated by a collag enous or myxocollagenous matrix. Mitotic activity was absent or minimal. Some of the lesional cells had a myofibroblastic immunophenotype, as evidenced by focal reactivity for muscle-specific and a-smooth muscle actins. In a few cases, rare actin-positive cells were also positive for keratins. Desmin, S100 protein, and CD34 were not expressed. None of the 39 patients with follow-up (median, 11 years) developed a recurrence. Collagenous fibroma is a benign fibroblastic/ myofibroblastic proliferation. The large size of some of these tumors coupled with slow growth and persistence favors a neoplastic process over a peculiar reactive proliferation. The differential diagnosis includes a variety of reactive and neoplastic fibroblastic lesions, most importantly fibromatosis and low-grade fibromyxoid sarcoma. Simple, conservative excision is the treatment of choice for collagenous fibroma.
copNew York, NY
pubElsevier Inc
pmid9670823
doi10.1016/S0046-8177(98)90275-1