Soft tissue

Fibroblastic / myofibroblastic

Nuchal type fibroma



Last author update: 1 June 2013
Last staff update: 31 July 2023

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PubMed Search: Nuchal-type fibroma OR Gardner-associated fibroma


Christine E. Jabcuga, M.D.
Jerad M. Gardner, M.D.
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Cite this page: Jabcuga C, Gardner JM. Nuchal type fibroma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/softtissuenuchaltypefibroma.html. Accessed March 29th, 2024.
Definition / general
  • Bundles of thick collagen fibers in posterior neck
  • Also called collagenosis nuchae, nuchal fibrocartilaginous pseudotumor, nuchal fibroma
  • Nuchal: nape (posterior) of neck
  • Related entities: Gardner associated fibroma (extra-nuchal location but essentially identical histology)
Epidemiology
  • Rare benign lesion of dermis and subcutis in posterior neck (70%), upper back or other regions
  • More common in men, mean age 40 years (age range 3 - 74 years)
  • Associated with diabetes mellitus in 44% (Cancer 1999;85:156)
Case reports
Treatment
  • Excision, may recur locally but does not metastasize
Gross description
  • Usually 3 cm or less, hard and white, unencapsulated, poorly circumscribed
Microscopic (histologic) description
  • No capsule, hypocellular, thick collagen fibers with delicate elastic fibers (Am J Surg Pathol 1995;19:313, Stanford University)
  • Entrapped adipose tissue and entrapped nerves (may resemble traumatic neuroma)
  • May infiltrate into skeletal muscle and adipose tissue, may have scattered lymphocytes
Microscopic (histologic) images

Contributed by Saima Absar, M.D., M.P.H. (Case #469) and AFIP

Nuchal type fibroma at extranuchal location


CD34

CD99

Strands of acellular collagen mixed with fat

Hypocellular lesion



Images hosted on other servers:

Figures 2 - 7

Positive stains
Negative stains
Differential diagnosis
  • Elastofibroma: prominent abnormal elastic fibers, subscapular location and often bilateral
  • Fibrolipoma: circumscribed, different location
  • Fibromatosis: deep soft tissue, not back of neck, more cellular with broad fascicles of fibroblasts
  • Gardner fibroma: same histologic features but extra-nuchal location (may be related or identical entity)
  • Solitary fibrous tumor: patternless pattern, more cellular, staghorn type vessels
Board review style question #1
Nearly half of patients with nuchal type fibroma will also carry what diagnosis?

A. Diabetes mellitus
B. Hypertension
C. Proteinuria
D. Turcot syndrome
Board review style answer #1
A. Diabetes mellitus

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