Myxoid lesions

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Myxoid lesions occasionally appear on the pathologist's desk. The differential diagnosis is very large, as many lesions have a myxoid variant.

Mucinous tumours redirects here; the terms myxoid and mucinous may be used interchangably.[1] Mucinous carcinoma is dealt with in its own article.

Short list

Myxoid stroma

Features:

  • Stroma has a pale/blue appearance.

Gastrointestinal pathology

Gynecologic pathology

Soft tissue pathology

Dermatopathology

Breast pathology

Kidney pathology

Salivary gland pathology

Cardiac pathology

Neuropathology

Chondromyxoid stroma

Features:

  • Cells in pseudonests.
  • Surrounding stroma bluish.

Salivary gland pathology

Dermatopathology

An exhaustive differential diagnosis for myxoid lesions

Adapted from Miller with modifications:[2]

Tumour Group Notes/comments
Perineurioma other
Spindle cell squamous carcinoma carcinoma
Myxoid pleomorphic undifferentiated sarcoma sarcoma myxoid MFH
Myxoid liposarcoma sarcoma
Lipoblastoma other
Myxoid chondrosarcoma sarcoma
Chordoma other
Myxoid leiomyoma mesenchymal lesion
Myxoid leiomyosarcoma sarcoma
Myxoid GIST mesenchymal lesion
Myxoid solitary fibrous tumour mesenchymal lesion
Myxoid omental-mesenteric hamartoma other
Myxoid neurofibroma other
Myxofibrosarcoma sarcoma some atypia, no swirling, vacuoles
Myxohyaline tumor of distal extremities other
Myxoid dermatofibroma other
Cutaneous myxoid cyst, cutaneous myxoma other
Cardiac myxoma other
Spindle cell lipoma mesenchymal lesion occasionally
Myxoma other brain-like appearance on CD34
Schwannoma other
Metastatic myxoid carcinoma carcinoma GI, ovary, breast
Myxoid fibrosarcoma sarcoma
Myxolipoma mesenchymal lesion
Focal mucinosis other
Appendiceal mucocele other Myxoglobulosis-like change
Mucocele of lip other Myxoglobulosis-like change
Mesenchymal hamartoma of liver other bile ducts in myxoid background
Angiomyxoma other
Inflammatory myxohyaline tumor of distal extremities other
Ossifying fibromyxoid tumor of soft parts other
Myxoid osteosarcoma sarcoma
Myxoinflammatory fibroblastic sarcoma sarcoma
Myxopapillary ependymoma other
Myxoid synovial sarcoma other
Neurothekeoma other myxoid variant
Aggressive angiomyxoma mesenchymal lesion
Angiomyofibroblastoma mesenchymal lesion
Giant cell angiofibroma mesenchymal lesion
Dermatofibrosarcoma protuberans other
Embryonal rhabdomyosarcoma sarcoma
Inflammatory myofibroblastic tumour other
Cellular blue nevus other
Superficial acral fibromyxoma mesenchymal lesion
Intamuscular myxoma mesenchymal lesion
Dermatofibroma other
Nodular fasciitis other

See also

References

  1. Layfield, LJ. (May 2003). "Cytologic differential diagnosis of myxoid and mucinous neoplasms of the sacrum and parasacral soft tissues.". Diagn Cytopathol 28 (5): 264-71. doi:10.1002/dc.10281. PMID 12722122.
  2. Miller RT. (Sep 2013). Atlantic Diagnostic Immunohistochemistry Symposium. St. John's, NL, Canada.