Difference between revisions of "Nodular fasciitis"

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| LMDDx      =
| LMDDx      =
| Stains    =
| Stains    =
| IHC        =
| IHC        = CD34 -ve, desmin -ve, SMA -ve, S-100 -ve, AE1/AE3 -ve.
| EM        =
| EM        =
| Molecular  =
| Molecular  = t(15;15) ?
| IF        =
| IF        =
| Gross      =
| Gross      =
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}}
}}
'''Nodular fasciitis''' is an uncommon [[soft tissue lesion]]. It should '''not''' to be confused with [[necrotizing fasciitis]].
'''Nodular fasciitis''' is an uncommon [[soft tissue lesion]]. It should '''not''' to be confused with [[necrotizing fasciitis]].
===General===
==General==
*Benign.
*Benign.
*All age groups.
*All age groups.
*Associated with trauma.
*Associated with trauma.


===Microscopic===
==Microscopic==
Features:<ref name=Ref_WMSP606>{{Ref WMSP|606}}</ref><ref>{{cite journal |author=de Feraudy S, Fletcher CD |title=Intradermal nodular fasciitis: a rare lesion analyzed in a series of 24 cases |journal=Am. J. Surg. Pathol. |volume=34 |issue=9 |pages=1377–81 |year=2010 |month=September |pmid=20716998 |doi=10.1097/PAS.0b013e3181ed7374 |url=}}</ref>
Features:<ref name=Ref_WMSP606>{{Ref WMSP|606}}</ref><ref>{{cite journal |author=de Feraudy S, Fletcher CD |title=Intradermal nodular fasciitis: a rare lesion analyzed in a series of 24 cases |journal=Am. J. Surg. Pathol. |volume=34 |issue=9 |pages=1377–81 |year=2010 |month=September |pmid=20716998 |doi=10.1097/PAS.0b013e3181ed7374 |url=}}</ref>
*Usu. well-circumscribed.
*Usu. well-circumscribed.
Line 73: Line 73:
www:
www:
*[http://www.humpath.com/nodular-fasciitis NF (humpath.com)].
*[http://www.humpath.com/nodular-fasciitis NF (humpath.com)].
===IHC===
==IHC==
Routine spindle cell panel:
Routine spindle cell panel:
*CD34 -ve.
*CD34 -ve.
*Desmin -ve.
*Desmin -ve.
*SMA -ve.
*SMA -ve.
*S100 -ve.
*S-100 -ve.
*AE1/AE3 -ve.
*AE1/AE3 -ve.


Line 86: Line 86:
*Vimentin +ve.
*Vimentin +ve.


===Molecular===
==Molecular==
*Evolving - case reports.
*Evolving - case reports.
**t(15;15)(q13;q25).<ref name=pmid12606136>{{cite journal |author=Velagaleti GV, Tapper JK, Panova NE, Miettinen M, Gatalica Z |title=Cytogenetic findings in a case of nodular fasciitis of subclavicular region |journal=Cancer Genet. Cytogenet. |volume=141 |issue=2 |pages=160–3 |year=2003 |month=March |pmid=12606136 |doi= |url=}}</ref>
**t(15;15)(q13;q25).<ref name=pmid12606136>{{cite journal |author=Velagaleti GV, Tapper JK, Panova NE, Miettinen M, Gatalica Z |title=Cytogenetic findings in a case of nodular fasciitis of subclavicular region |journal=Cancer Genet. Cytogenet. |volume=141 |issue=2 |pages=160–3 |year=2003 |month=March |pmid=12606136 |doi= |url=}}</ref>

Revision as of 03:05, 29 September 2013

Nodular fasciitis
Diagnosis in short

Nodular fasciitis. H&E stain.
LM usu. well-circumscribed, clusters of (non-pleomorphic) spindle cells, inflammation (lymphocytes), microcysts in cellular regions - uncommon, mitoses - common, extravasated RBCs.
IHC CD34 -ve, desmin -ve, SMA -ve, S-100 -ve, AE1/AE3 -ve.
Molecular t(15;15) ?
Site soft tissue - fibroblastic/myofibroblastic tumours
Clinical history associated with trauma
Prevalence uncommon
Prognosis benign

Nodular fasciitis is an uncommon soft tissue lesion. It should not to be confused with necrotizing fasciitis.

General

  • Benign.
  • All age groups.
  • Associated with trauma.

Microscopic

Features:[1][2]

  • Usu. well-circumscribed.
  • Clusters of (non-pleomorphic) spindle cells.
  • Inflammation (lymphocytes).
  • Microcysts in cellular regions - uncommon - discriminatory.
  • Mitoses - common.
  • Extravasated RBCs.

The BD feature list:[3][4]

  • Tissue culture-like/CNS-like morphology.
  • Thick (keloid-like) collagen bundles - key feature.
  • Extravasated RBCs.
  • Inflammation.
  • +/-Giant cells.

Notes:

  • No significant nuclear atypia.
  • No atypical mitoses.
  • May be cellular.

DDx:[5]

Images

  • NF - case 1 - intermed. mag. (WC)

  • NF - case 1 - high mag. (WC)

  • NF - case 2 - intermed. mag. (WC)

  • NF - case 2 - high mag. (WC)

  • NF - low mag. (WC)

  • NF - high mag. (WC)

www:

IHC

Routine spindle cell panel:

  • CD34 -ve.
  • Desmin -ve.
  • SMA -ve.
  • S-100 -ve.
  • AE1/AE3 -ve.

Others:

  • H-caldesmon -ve.
  • EMA -ve.
  • Vimentin +ve.

Molecular

  • Evolving - case reports.
    • t(15;15)(q13;q25).[6]

See also

References

  1. ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 606. ISBN 978-0781765275.
  2. ↑ de Feraudy S, Fletcher CD (September 2010). "Intradermal nodular fasciitis: a rare lesion analyzed in a series of 24 cases". Am. J. Surg. Pathol. 34 (9): 1377–81. doi:10.1097/PAS.0b013e3181ed7374. PMID 20716998.
  3. ↑ Dickson, B. 26 April 2011.
  4. ↑ URL: http://anvita.info/wiki/Nodular_Fasciitis. Accessed on: 11 November 2011.
  5. ↑ URL: http://www.mckeedermpath.com/SPOT%20DIAGNOSIS%20CASE%20268.html. Accessed on: 11 November 2011.
  6. ↑ Velagaleti GV, Tapper JK, Panova NE, Miettinen M, Gatalica Z (March 2003). "Cytogenetic findings in a case of nodular fasciitis of subclavicular region". Cancer Genet. Cytogenet. 141 (2): 160–3. PMID 12606136.
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