Soft tissue
Fibroblastic / myofibroblastic
Angiomyofibroblastoma


Topic Completed: 1 July 2014

Minor changes: 14 September 2020

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PubMed Search: Angiomyofibroblastoma


Komal Arora, M.D.
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Cite this page: Arora K. Angiomyofibroblastoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/softtissueangiomyofibroblastoma.html. Accessed September 20th, 2020.
Definition / general
  • Benign, well-circumscribed myofibroblastic tumor, usually in vulva
  • May overlap with cellular angiofibroma
  • First described in 1992 (Am J Surg Pathol 1992;16:373)
Clinical features
  • Uncommon slow growing painless mass, usually females of reproductive age
Sites
  • Usually vulvar, 10 - 15% in vagina
  • Also scrotum or paratesticular soft tissue in men (median age 57 years)
Case reports
Treatment
  • Excision, only rarely recurs, does not metastasize
Gross description
  • Well circumscribed but not encapsulated, usually 5 - 7 cm or less, tan-pink soft cut surface, no necrosis
Gross images

Contributed by Mark R. Wick, M.D.

Scrotum

Microscopic (histologic) description
  • Thin fibrous pseudocapsule, alternating hyper- and hypocellular areas with prominent thin walled and ectatic vessel in edematous stroma (Mod Pathol 1996;9:284)
  • Round to spindled tumor cells have eosinophilic cytoplasm and often bi- or multi-nucleation
  • May have plasmacytoid or epithelioid morphology, or rarely show degenerative changes
  • Tumor cells are concentrated around vessels
  • Mast cells common
  • 10% have mature adipose tissue
  • No / rare mitotic figures, no / rare red blood cell extravasation, no atypia
  • Most menopausal patients have less cellularity, less edema but more fibrosis and vessel wall hyalinization
Microscopic (histologic) images

Contributed by Mark R. Wick, M.D.

Scrotum

Vulva



Images hosted on other servers:

Arising from posterior perivesical space

Numerous capillary-like vascular channels

Positive stains
Negative stains
Electron microscopy description
  • Myofibroblastic and fibroblastic features
Differential diagnosis
  • Aggressive angiomyxoma: not circumscribed, > 5 cm, less cellular, less vascular but vessels are large and thick walled, stromal mucin and RBC extravasation are present, infrequent plump stromal cells, usually actin negative
  • Cellular angiofibroma: more cellular uniformly, perivascular hyalinization and large, thick walled vessels, usually actin/desmin negative
  • Epithelioid leiomyoma: more cellular, no biphasic pattern, usually no binucleation, no / rare mast cells
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