Table of Contents
Definition / general | Gross description | Microscopic (histologic) description | Positive stains | Differential diagnosis | Additional referencesCite this page: Perunovic, B. Pseudosarcomatous fibroepithelial stromal polyps. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixpseudosarcomatous.html. Accessed March 9th, 2021.
Definition / general
- Median age 32 years, range 16 to 75 years
- Often in pregnant patients or postoperative
- May recur locally; no metastases
- Positive margin status, which is common, apparently is not associated with recurrence
Gross description
- Often multiple lesions, particularly in pregnant women
- Tender, skin-colored, sac-like
Microscopic (histologic) description
- Resemble fibroepithelial stromal polyps of vagina and vulva, but with bizarre morphology, frequent mitoses (>10/10 HPF), atypical mitotic figures or hypercellularity
- Clues to diagnosis are characteristic stellate cells and multinucleate stromal cells, and extension of lesions up to mucosal-submucosal interface
Differential diagnosis
- Aggressive angiomyxoma: deep, prominent vascular pattern cuffed by myoid bundles
- Angiomyofibroblastoma: well circumscribed subserosal nodule, no atypia, stromal cells cluster around vessels, which usually have delicate walls
- Botryoid embryonal rhabdomyosarcoma: early childhood, submucosal hypercellular zone/cambium layer, rhabdomyoblasts, myoglobin+, myogenin+
- Cellular angiofibroma: well circumscribed, less polypoid, diffusely vascular with hyalinized walls, no atypical stromal cells, desmin-
- Leiomyosarcoma: clear boundary of tumor cells with epithelium, smooth muscle differentiation
- Low grade endometrial stromal sarcoma: vessels resemble spiral arterioles, no central vascular core, thick bands of collagen in starburst pattern, dot like staining of desmin or keratin
- Malignant peripheral nerve sheath tumor: perivascular accentuation, 50% are S100+
Additional references