Anatomic pathology fnac changes in pseudosarcomatous lesions. Nodular fasciitis nf is generally regarded as a benign, tumorlike proliferation of myofibroblasts, that typically occurs in the extremities, originally described by konwaller et al. We present a case of eosinophilic fasciitis, or shulman syndrome, in a 35yearold man and discuss its clinical and histopathologic aspects, as well as its relationship to scleroderma. Embryology the endometrium and the myometrium are of mesodermal origin and are formed secondary to fusion of the mullerian paramesonephric ducts between the 8th and 9th postovulatory weeks. Nodular fasciitis classic morphologic variants related tumors ischemic fasciitis proliferative fasciitis myositis ossificans intraabdominal myofibroblastic proliferations visceral tumors. Proliferative fasciitis and proliferative myositis can look scary. The clinical, microscopical, immunocytochemical and ultrastructural features of five cases of benign mesenchymal proliferative lesions of the urinary bladder, mimicking sarcoma, are presented. Proliferative myositis pm is a rare benign inflammatory. Nodular fasciitis, first described by konwaler and weiss in 1955 is also known as pseudosarcomatous fasciitis, pseudosarcomatous fibromatosis and infiltrative fasciitis. Mri findings, available in all 10 patients, were compared with.
Proliferative fasciitis surgical pathology criteria. It is slow to penetrate, hardens and shrinks the tissue. Nodular fasciitis presents as a rapidly growing soft tissue mass which may follow a history of trauma histology of nodular fasciitis. Proliferative fasciitis is a subcutaneous or fascial reactive process that contains fibroblasts and myofibroblasts.
Although controversial, the tendency is to set shulman syndrome apart from all other sclerodermiform states. The head and neck region is a common location for nf, particularly in children, but nf of the parotid gland is rare. Histological procedures aim to provide good quality sections that can be used for a light microscopic evaluation of human or animal tissue changes in. Carnoys fixative is used to increase the speed of tissue processing. A fifth patient, who had a pseudosarcomatous stromal response. A comparative study of their proliferative activity using proliferating cell nuclear antigen, dna flow cytometry, and p53. Since they appear as rapidly growing masses, pm and nf are easily and mistakenly diagnosed as each other or even as sarcoma 1,3. Mar 16, 2020 webpathology is a free educational resource with 10236 high quality pathology images of benign and malignant neoplasms and related entities. Grouped with solitary fibrous tumour in the who classification. Laboratory studies elicited evidence of active viral infection in 2 patients human herpes virus 6 and rotavirus.
Nodular fasciitis was originally described in 1955 by konwaler et al and is synonymous with pseudosarcomatous and infiltrative fasciitis, terms which reflect the lesions rapid growth, dense cellularity, alarming mitotic activity, and lack of circumscription. The aim of this paper is to present the characteristic magne the aim of this paper is to present the characteristic magne tic resonance imaging mri findings of pm, and thus to avoid the pitfalls of overdiagnosis. Proliferative fasciitis is a well recognized variant and is composed of epithelioid cells which resemble ganglion cells figure 3. It is one of the most underdiagnosed lesion and can be confused with spindle cell sarcoma, fibromatosis, fibrous histiocytoma, proliferative fasciitis, benign nerve sheath tumors, and pleomorphic. Nodular fasciitis, proliferative fasciitis definition of. These are benign reactive lesions of soft tissue, but they can easily get confused with sarcoma because of. A 61year old man had a hard mass in his right lower leg that had rapidly increased in size in the past 10 days. Printable proliferative fasciitis surgical pathology. Pathology of the endometriumpathology of the endometrium thomas c. Chapter 1 introducton histopathology definition it is a branch of pathology which deals with the study of disease in a tissue section. Proliferative fasciitis is common in the extremities, specially in the lower limb. Histopathologic examination of hematoxylin and eosin. Proliferative fasciitis is a pseudosarcomatous, benign proliferation of myofibroblasts that is most often seen in patients older than 40 years mean age, 54 years, 1, 21. On grayscale us, there are a few reports 3 that the lesions were.
Ushigome s, takakuwa t, takagi m, koizumi h, morikubo m. Dilated proliferativedilated proliferative type glands, with pseudostratification increased gland. It is identical to proliferative myositis except that it arises in an extramuscular location. Proliferative myositis is common in shoulder girdle and upper trunk. Fixation, tissue processing, histologyand immunohistochemistry procedures for diagnosis of animal tse bse, scrapie, atypical scrapie,cwd pathology department, apha. Proliferative fasciitis and proliferative myositis are uncommon fibroblastic reactive softtissue lesions, 2. Myxoid tumors can be benign including locally aggressive tumors or frankly malignant. Correlation of mri findings and histopathology article in skeletal radiology 3. Histopathological examination of all the cases showed spindle cells which are the proliferating fibroblasts and myofibroblasts interspersed with. Andrew horvai, md, phd associate clinical professor, pathology disclosures i have nothing to disclose. Pathologic and mr imaging features of benign fibrous soft. Nodular fasciitis of the masseter bmj case reports. This is a benign pseudosarcomatous lesion which normally runs a selflimiting course. It is one of the most underdiagnosed lesion and can be confused with spindle cell sarcoma, fibromatosis, fibrous histiocytoma, proliferative fasciitis, benign nerve sheath tumors, and pleomorphic adenoma because of features.
From the department of pathology, james homer wright laboratories, massachusetts general hospital, harvard medical school, boston. Differential diagnosis proliferative fasciitis surgical. We present a case of proliferative fasciitis arising adjacent to an operative scar of the right lower leg of a patient with chronic lymphatic leukemia, diabetes mellitus, and multiple subcutaneous angiolipomas. Endometrial histopathologybasics linkedin slideshare. Braz j vet pathol, 2009, 21, 41 44 brazilian journal of veterinary pathology. Nodular fasciitis from an established cytogenetic viewpoint.
Wright columbia university, new york, ny changes in the uterus th h t lifthoughout life there are marked changes in the size of the uterus. Eosinophilic fasciitis shulman syndrome mdedge dermatology. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. A light and electron microscopic, cytologic, dnacytometric and immunohistochemical study. Proliferative phase endometrium, abbreviated ppe, is a very common diagnosis in endometrial specimens. Professor of pathology, howard university, wash ington, dc.
Fine needle aspiration cytology of pseudosarcomatous. Pseudosarcomas of soft tissue archives of pathology. Necrotizing fasciitis is a rapidly progressive often fatal softtissue infection most commonly resulting from polymicrobial infection. Alcohol penetrates rapidly in presence of other fixative hence incombination e. Histopathology remains one of the major tools of diagnosis in mycology20 table 3. A 35yearold japanese woman presented with a tender. One of the most common and important pitfalls in soft tissue pathology are the socalled pseudosarcomas. Clinical and histopathologic findings of 9 patients. Proliferative myositis pm and nodular fasciitis nf are within a spectrum of benign myofibroblastic tumorlike lesions 1,2. We report a case of proliferative fasciitis, pseudotumorous fibrous proliferation similar to nodular fasciitis, showing evolution and involution during a 1month period. Proliferative myositis is a poorly defined scarlike lesion involving muscle and overlying fascia. Pseudosarcomatous fasciitis and myositis diagnosis by fine.
On histopathology, there were skeletal muscle fibers and fibrocollagenous tissue with chronic inflammatory cells, proliferating fibroblasts and giant cells. When interpreting mr images of softtissue masses in adults, radiologists should be aware of the clinical behavior, common sites of occurrence, and histopathologic and imaging features of the common benign fibrous softtissue tumors. Pdf proliferative fasciitis pf is a benign lesion with histologic and. Resembles nodular fasciitis due to zonation effect, tissue culture type growth and plump fibroblastic and myofibroblastic spindle cells, but has large ganglionlike cells with abundant amphophilic to basophilic cytoplasm, round vesicular nuclei occasionally 2 3 nuclei and prominent nucleoli. These are benign reactive lesions of soft tissue, but they can easily get confused with sarcoma because of their huge weird. Scanning power view of eosinophilic fasciitis shows a sclerosing process affecting the deep subcutaneous tissue and fascia figure 1.
Reactive fibrous proliferations pathology of proliferative. Lundgren l, kindblom lg, willems j, falkmer u, angervall l. Ten patients with nf, nine females and 1 male, with an age ranging from to 58 years mean 26. Nodular fasciitis was first described by konwaler, who named it pseudo sarcomatous fasciitis because of its resemblance to sarcoma. Meijer introduction rhabdomyosarcoma rms is a soft tissue sarcoma which displays features of skeletal muscle differentia tion.
Pathology of the endometriumpathology of the endometrium. With time the collagen becomes thickened and sclerotic figure. The major advantages of histopathology are speed, low cost and the ability to provide a presumptive identification of the infecting fungus as well as demonstrating the tissue reaction. Proliferative fasciitis and proliferative myositis. Nodular fasciitis is a benign proliferation of fibroblasts in the subcutaneous tissues, commonly associated with the deep fascia. Low power examination of nodular fasciitis shows a wellcircumscribed discrete mass in the subcutaneous adipose tissue figure 1. Proliferative myositis and ischemic fasciitis differ from proliferative fasciitis only by location and clinical presentation proliferative fasciitis nodular fasciitis. The tissue undergoes a series of steps before it reaches the examiners desk to be thoroughly examined microscopically to arrive at. It acts as a reducing agents, become oxidized to acetaldehyde and then to acetic acid.
After surgical excision, immunohistochemical analysis showed this was in fact nodular fasciitis of the masseter. Nodular fasciitis is a rare, benign, proliferative lesion whose clinical and histological features make it difficult to distinguish from malignancies such as. This disease affects primarily middleaged and older individuals and is rare in children. Fibroblasticmyofibroblastic tumours libre pathology. Due to the histopathology with its high cellularity and high mitotic. The process initially begins in the superficial fascial planes and progresses into the deep fascial layers causing necrosis by microvascular occlusion. Nodular fasciitis nf is a relatively common massforming and selflimited subcutaneous pseudosarcomatous myofibroblastic proliferation of unknown pathogenesis. A process of evolution and involution is a characteristic feature of reactive fibrous lesions, but has not been emphasized in either the radiology or pathology literature. Nodular fasciitis is also known as psedosarcomatous fibromatosis, proliferative fasciitis and infiltrative fasciitis 14. Rapid involution of proliferative fasciitis springerlink. Subcutaneous or fascial reactive process composed of large ganglionlike cells, fibroblasts and myofibroblasts set in a myxoid. To achieve this it is important that the tissue must be prepared in such a manner.
The tissue undergoes a series of steps before it reaches the examiners desk to be thoroughly examined microscopically to arrive at a particular diagnosis. Nodular fasciitis, proliferative fasciitis, proliferative. It is a branch of pathology which deals with the study of disease in a tissue section. Report of a case with histopathologic and immunohistochemical studies. Nodular fasciitis is a relatively common soft tissue tumor that exceeds in frequency. Department of diagnostic pathology, st marianna university school of medicine, kawasaki, japan.
Histopathology for the diagnosis of infectious diseases e gupta, p bhalla, n khurana, t singh. A few genetic studies have suggested that this lesion may be a benign neoplasm, rather than just a purely reactive phenomenon. Grossly, proliferative fasciitis resembles nodular fasciitis. The fourth edition of the world health organization who classification of tumors of soft tissue and bone published in 20 updated the older 2002 classification, introduced several changes in softtissue tumor classification, and described new genetic and molecular data for the tumors 5, 6. Millwardsadler from southampton general hospital this is the first report of proliferative fasciitis presenting in a finger. The features were consistent with a diagnosis of proliferative myositis. Jan 11, 2018 proliferative fasciitis and proliferative myositis can look scary. To compare the histopathology of nodular fasciitis nf with the magnetic resonance imaging mri findings in order to evaluate the basis of the mr signal characteristics. Histopathology shows a focal wellcircumscribed deposit of mucin in the dermis with no or few. It is an idiopathic, reactive, self limited proliferation of fibroblast. The myofibroblasts are positive with smooth muscle actin, calponin.
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