Soft tissue

Fibroblastic / myofibroblastic

Cellular angiofibroma

Last author update: 1 July 2012
Last staff update: 6 February 2023 (update in progress)

Copyright: 2002-2023,, Inc.

PubMed Search: Cellular angiofibroma

Komal Arora, M.D.
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Cite this page: Arora K. Cellular angiofibroma. website. Accessed June 10th, 2023.
Definition / general
  • Benign, highly cellular tumor of vulva and scrotum / inguinal region with prominent blood vessels
  • Also called angiomyofibroblastoma-like lesion
  • First described in 1997 (Am J Surg Pathol 1997;21:636)
  • Related to spindle cell lipoma and mammary-type myofibroblastoma, with morphological variations dependent on anatomic location (Mod Pathol 2011;24:82)
  • In women, may arise from hormone receptor positive mesenchymal cells in lower female genital tract (Histopathology 2004;45:360)
Clinical features
  • Rare; usually ages 40+ years
  • Extragenital cases have similar features (APMIS 2007;115:254)
Case reports
Gross description
  • Vulvar lesions are usually up to 3 cm, male lesions may reach 14 cm
  • Well circumscribed nodules with soft to rubbery, gray-pink-brown cut surface
Microscopic (histologic) description
  • Well circumscribed, variable pseudocapsule
  • Cellular tumor with fascicles or haphazard pattern
  • Bland spindle cells with scant, lightly eosinophilic cytoplasm with ill defined borders, oval to fusiform nucleus
  • May be epithelioid
  • Prominent small to medium-sized vessels with hyaline fibrosis in walls
  • Vessels may have degenerative changes of fibrin thrombi, intramural inflammation, hemosiderin
  • Some (usually 5% or less) adipose tissue present in 50%
  • Stroma is usually fine collagenous fibers
  • Scattered mast cells are common
  • Female lesions may have brisk mitotic activity, usually absent/rare in males
  • Occasional atypia or sarcomatous transformation (Am J Surg Pathol 2010;34:707)
  • No necrosis, no atypical mitotic figures
Microscopic (histologic) images

Images hosted on other servers:

Various images

Recurrent tumor


Occasional features

Typical features of CAF

Malignant cases


Positive stains
Negative stains
Molecular / cytogenetics description
Differential diagnosis
  • Aggressive angiomyxoma: usually large and deep, hypocellular, infiltrative margin, desmin+
  • Angiomyofibroblastoma: less uniform cellularity, smaller vessels, usually desmin+
  • Leiomyoma: spindled cytoplasm, actin+, desmin+
  • Perineurioma
  • PHAT
  • Solitary fibrous tumor: hyper- and hypocellular areas, prominent staghorn vessels, hyalinized collagen CD34+
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