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Soft tissue
Fibroblastic / myofibroblastic tumors
Myxoinflammatory fibroblastic sarcoma

Reviewer: Annie S. Morrison, M.D. (see Reviewers page)
Editor: Jerad M. Gardner, M.D.
Revised: 10 January 2014, last major update April 2013
Copyright: (c) 2002-2013, PathologyOutlines.com, Inc.

Definition
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Epidemiology
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Case reports
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Treatment
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Gross description
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Micro description
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Micro images
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Fibrous region with inflammatory cells
Myxoid region with inflammatory cells
Acute inflammatory cells

AFIP: myxoid nodule has
characteristic ganglion-type
cells with prominent nucleoli
Nodules of cells infiltrating ulnar nerve
Sheetlike proliferation of spindle cells
Spindle cells with prominent nucleoli
Various images
Figures 2, 3, 4
Case of the Week #296 -






Cytology description
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Cytology images
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Figure 1

Positive stains
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  • Vimentin, usually CD34, CD163 and EGFR; variable CD68
Negative stains
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  • CD45, T and B cell markers
Electron microscopy description
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  • Fibroblastic features of abundant rough endoplasmic reticulum and mitochondria, intermediate filaments
  • Lipoblast like cells have cytoplasmic pseudoinclusions with extracellular mucin
Molecular / cytogenetics description
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Differential diagnosis
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  • Epithelioid sarcoma: most cells are round with dense eosinophilic cytoplasm, strongly keratin+, loss of INI1 (SMARCB)
  • Hodgkin lymphoma: lacks giant cells and lipoblast-like cells, tumor cells have different staining patterns
  • Myxofibrosarcoma: rare in soft tissues of hands and feet, more frequent mitotic figures with atypical forms, no inflammatory infiltrate
  • Pleomorphic liposarcoma: true pleomorphic lipoblasts, rare in soft tissues of hands and feet, more frequent mitotic figures with atypical forms, no inflammatory infiltrate
  • Rosai-Dorfman disease: emperipolesis, but no intranuclear viral-like inclusions, S100+, usually not myxoid
  • Tenosynovitis: no enlarged atypical cells
End of Soft tissue > Fibroblastic / myofibroblastic tumors > Myxoinflammatory fibroblastic sarcoma


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