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Table of Contents
Definition / general | Epidemiology | Sites | Clinical features | Prognostic factors | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Negative stains | Electron microscopy description | Differential diagnosis | Additional referencesCite this page: Mansouri, J. Angiomyofibroblastoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/vaginaangiomyofibroblastoma.html. Accessed August 19th, 2018.
Definition / general
- Benign vulvar and vaginal tumor, first described in 1992 (Am J Surg Pathol 1992;16:373)
- No reported recurrences after excision
Epidemiology
- Females of reproductive age (10% of patients are postmenopausal)
- Very rarely in males (scrotum, paratesticular tissue)
Sites
- Vagina (10 - 15% of cases)
- Vulva (majority of cases)
Clinical features
- Presents as slowly enlarging and painless mass
- May be mistaken for Bartholin cyst or genital prolapse
Prognostic factors
- Benign, rarely recurs when marginally excised
- Important to rule out angiomyxomatous or sarcomatous foci in rare cases
Case reports
- 80 year old woman with angiomyofibroblastoma of the vagina and postmenopausal breast cancer treated with tamoxifen (Int J Gynecol Cancer 2006;16:581)
- 80 year old woman with angiomyofibroblastoma of the vulva with sarcomatous transformation (Am J Surg Pathol 1997;21:1104)
Treatment
- Local excision
Gross description
- Well circumscribed, soft, 0.5 to 12.0 cm, without necrosis
- May have pseudocapsule
Microscopic (histologic) description
- Circumscribed tumor with alternating hypercellular and hypocellular areas, spindle cells and plump stromal cells with eosinophilic cytoplasm that aggregate around small blood vessels
- May have binucleated or multinucleated cells
- Mast cells common
- Minimal stromal mucin, rare / no red blood cell extravasation, no atypia
- Rare / no mitotic figures
Microscopic (histologic) images
Images hosted on other servers:
Zones of hypo and hypercellularity
Round to oval, plump spindle cells
Cytology description
- Tumor cells with epithelioid or plasmacytoid features, may be binucleated or multinucleated
Electron microscopy description
- Well developed rough endoplasmic reticulum, Golgi apparatus, intermediate filaments, pinocytotic vesicles
Differential diagnosis
- Angiomyxoma: not circumscribed, less cellular, fewer vessels; stromal mucin, RBC extravasation, infrequent plump stromal cells, no hyalinized vessels
- Cellular angiofibroma: hyalinized vessels, infrequent epithelioid or plasmacytoid nuclear features, more cellular, more fibrous stroma
- Fibroepithelial stromal polyp of vagina: no uninvolved Grenz zone; cells extend to dermal - epidermal junction (Int J Gynecol Pathol 2005;24:26)
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