Braz j vet pathol, 2009, 21, 41 44 brazilian journal of veterinary pathology. Grossly, proliferative fasciitis resembles nodular fasciitis. The clinical, microscopical, immunocytochemical and ultrastructural features of five cases of benign mesenchymal proliferative lesions of the urinary bladder, mimicking sarcoma, are presented. Subcutaneous or fascial reactive process composed of large ganglionlike cells, fibroblasts and myofibroblasts set in a myxoid. Laboratory studies elicited evidence of active viral infection in 2 patients human herpes virus 6 and rotavirus.
Histopathology remains one of the major tools of diagnosis in mycology20 table 3. It is a branch of pathology which deals with the study of disease in a tissue section. Fibroblasticmyofibroblastic tumours libre pathology. A 35yearold japanese woman presented with a tender. Nodular fasciitis was originally described in 1955 by konwaler et al and is synonymous with pseudosarcomatous and infiltrative fasciitis, terms which reflect the lesions rapid growth, dense cellularity, alarming mitotic activity, and lack of circumscription. Pdf proliferative fasciitis pf is a benign lesion with histologic and. Nodular fasciitis was first described by konwaler, who named it pseudo sarcomatous fasciitis because of its resemblance to sarcoma. Mar 16, 2020 webpathology is a free educational resource with 10236 high quality pathology images of benign and malignant neoplasms and related entities.
These are benign reactive lesions of soft tissue, but they can easily get confused with sarcoma because of their huge weird. A comparative study of their proliferative activity using proliferating cell nuclear antigen, dna flow cytometry, and p53. Proliferative fasciitis and proliferative myositis. Scanning power view of eosinophilic fasciitis shows a sclerosing process affecting the deep subcutaneous tissue and fascia figure 1. Ushigome s, takakuwa t, takagi m, koizumi h, morikubo m. Necrotizing fasciitis is a rapidly progressive often fatal softtissue infection most commonly resulting from polymicrobial infection. Resembles nodular fasciitis due to zonation effect, tissue culture type growth and plump fibroblastic and myofibroblastic spindle cells, but has large ganglionlike cells with abundant amphophilic to basophilic cytoplasm, round vesicular nuclei occasionally 2 3 nuclei and prominent nucleoli. Proliferative myositis pm is a rare benign inflammatory.
Nodular fasciitis, proliferative fasciitis definition of. Histopathology shows a focal wellcircumscribed deposit of mucin in the dermis with no or few. Since they appear as rapidly growing masses, pm and nf are easily and mistakenly diagnosed as each other or even as sarcoma 1,3. Nodular fasciitis from an established cytogenetic viewpoint. Andrew horvai, md, phd associate clinical professor, pathology disclosures i have nothing to disclose. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Alcohol penetrates rapidly in presence of other fixative hence incombination e. Nodular fasciitis nf is generally regarded as a benign, tumorlike proliferation of myofibroblasts, that typically occurs in the extremities, originally described by konwaller et al. On histopathology, there were skeletal muscle fibers and fibrocollagenous tissue with chronic inflammatory cells, proliferating fibroblasts and giant cells. Proliferative fasciitis is a pseudosarcomatous, benign proliferation of myofibroblasts that is most often seen in patients older than 40 years mean age, 54 years, 1, 21. The major advantages of histopathology are speed, low cost and the ability to provide a presumptive identification of the infecting fungus as well as demonstrating the tissue reaction. A 61year old man had a hard mass in his right lower leg that had rapidly increased in size in the past 10 days.
Nodular fasciitis is a benign proliferation of fibroblasts in the subcutaneous tissues, commonly associated with the deep fascia. Proliferative fasciitis and proliferative myositis can look scary. A light and electron microscopic, cytologic, dnacytometric and immunohistochemical study. Low power examination of nodular fasciitis shows a wellcircumscribed discrete mass in the subcutaneous adipose tissue figure 1. Histopathologic examination of hematoxylin and eosin. Proliferative myositis pm and nodular fasciitis nf are within a spectrum of benign myofibroblastic tumorlike lesions 1,2. The tissue undergoes a series of steps before it reaches the diagnosis. Anatomic pathology fnac changes in pseudosarcomatous lesions. Pseudosarcomatous fasciitis and myositis diagnosis by fine.
Nodular fasciitis classic morphologic variants related tumors ischemic fasciitis proliferative fasciitis myositis ossificans intraabdominal myofibroblastic proliferations visceral tumors. Nodular fasciitis is also known as psedosarcomatous fibromatosis, proliferative fasciitis and infiltrative fasciitis 14. Myxoid tumors can be benign including locally aggressive tumors or frankly malignant. Professor of pathology, howard university, wash ington, dc. Chapter 1 introducton histopathology definition it is a branch of pathology which deals with the study of disease in a tissue section. It is identical to proliferative myositis except that it arises in an extramuscular location. Endometrial histopathologybasics linkedin slideshare. It is slow to penetrate, hardens and shrinks the tissue. Reactive fibrous proliferations pathology of proliferative. This is a benign pseudosarcomatous lesion which normally runs a selflimiting course. A few genetic studies have suggested that this lesion may be a benign neoplasm, rather than just a purely reactive phenomenon.
A fifth patient, who had a pseudosarcomatous stromal response. Pathologic and mr imaging features of benign fibrous soft. Pdf intraoral nodular nodular fasciitis is a rare entity that is important to recognize because it may. Fibrosarcoma versus fibromatoses and cellular nodular fasciitis. Lundgren l, kindblom lg, willems j, falkmer u, angervall l. Proliferative fasciitis is a well recognized variant and is composed of epithelioid cells which resemble ganglion cells figure 3.
Due to the histopathology with its high cellularity and high mitotic. Proliferative fasciitis is common in the extremities, specially in the lower limb. Report of a case with histopathologic and immunohistochemical studies. Proliferative fasciitis and proliferative myositis are uncommon fibroblastic reactive softtissue lesions, 2. Nodular fasciitis of the masseter bmj case reports.
Millwardsadler from southampton general hospital this is the first report of proliferative fasciitis presenting in a finger. Ten patients with nf, nine females and 1 male, with an age ranging from to 58 years mean 26. One of the most common and important pitfalls in soft tissue pathology are the socalled pseudosarcomas. These are benign reactive lesions of soft tissue, but they can easily get confused with sarcoma because of.
Fixation, tissue processing, histologyand immunohistochemistry procedures for diagnosis of animal tse bse, scrapie, atypical scrapie,cwd pathology department, apha. Histopathological examination of all the cases showed spindle cells which are the proliferating fibroblasts and myofibroblasts interspersed with. In early disease there is oedema of the fascia and subcutaneous tissue with a lymphocytic infiltrate containing plasma cells and eosinophils. This disease affects primarily middleaged and older individuals and is rare in children. Fine needle aspiration cytology of pseudosarcomatous. Nodular fasciitis presents as a rapidly growing soft tissue mass which may follow a history of trauma histology of nodular fasciitis. Proliferative myositis is common in shoulder girdle and upper trunk. Although controversial, the tendency is to set shulman syndrome apart from all other sclerodermiform states. It is one of the most underdiagnosed lesion and can be confused with spindle cell sarcoma, fibromatosis, fibrous histiocytoma, proliferative fasciitis, benign nerve sheath tumors, and pleomorphic adenoma because of features. The features were consistent with a diagnosis of proliferative myositis. Histological procedures aim to provide good quality sections that can be used for a light microscopic evaluation of human or animal tissue changes in. The fourth edition of the world health organization who classification of tumors of soft tissue and bone published in 20 updated the older 2002 classification, introduced several changes in softtissue tumor classification, and described new genetic and molecular data for the tumors 5, 6. Proliferative myositis is a poorly defined scarlike lesion involving muscle and overlying fascia.
Giant cells had abundant dense eosinophilic cytoplasm and vesicular nuclei with prominent nucleoli. Pathology of the endometriumpathology of the endometrium thomas c. It is one of the most underdiagnosed lesion and can be confused with spindle cell sarcoma, fibromatosis, fibrous histiocytoma, proliferative fasciitis, benign nerve sheath tumors, and pleomorphic. It acts as a reducing agents, become oxidized to acetaldehyde and then to acetic acid. Clinical and histopathologic findings of 9 patients. Nodular fasciitis, first described by konwaler and weiss in 1955 is also known as pseudosarcomatous fasciitis, pseudosarcomatous fibromatosis and infiltrative fasciitis.
Proliferative phase endometrium, abbreviated ppe, is a very common diagnosis in endometrial specimens. Nodular fasciitis is a rare, benign, proliferative lesion whose clinical and histological features make it difficult to distinguish from malignancies such as. Proliferative myositis and ischemic fasciitis differ from proliferative fasciitis only by location and clinical presentation proliferative fasciitis nodular fasciitis. We present a case of proliferative fasciitis arising adjacent to an operative scar of the right lower leg of a patient with chronic lymphatic leukemia, diabetes mellitus, and multiple subcutaneous angiolipomas. On grayscale us, there are a few reports 3 that the lesions were. Pseudosarcomas of soft tissue archives of pathology. Carnoys fixative is used to increase the speed of tissue processing. From the department of pathology, james homer wright laboratories, massachusetts general hospital, harvard medical school, boston. After surgical excision, immunohistochemical analysis showed this was in fact nodular fasciitis of the masseter.
We propose the following features as the main criteria of shjcm. Grouped with solitary fibrous tumour in the who classification. Nodular fasciitis nf is a relatively common massforming and selflimited subcutaneous pseudosarcomatous myofibroblastic proliferation of unknown pathogenesis. The process initially begins in the superficial fascial planes and progresses into the deep fascial layers causing necrosis by microvascular occlusion. We report a case of proliferative fasciitis, pseudotumorous fibrous proliferation similar to nodular fasciitis, showing evolution and involution during a 1month period. Differential diagnosis proliferative fasciitis surgical. Proliferative fasciitis is a subcutaneous or fascial reactive process that contains fibroblasts and myofibroblasts. Printable proliferative fasciitis surgical pathology. A process of evolution and involution is a characteristic feature of reactive fibrous lesions, but has not been emphasized in either the radiology or pathology literature. The myofibroblasts are positive with smooth muscle actin, calponin.
With time the collagen becomes thickened and sclerotic figure. It is an idiopathic, reactive, self limited proliferation of fibroblast. Correlation of mri findings and histopathology article in skeletal radiology 3. Histopathology techniques histopathology definition. Histopathology for the diagnosis of infectious diseases e gupta, p bhalla, n khurana, t singh. Nodular fasciitis, proliferative fasciitis, proliferative. Department of diagnostic pathology, st marianna university school of medicine, kawasaki, japan. Nodular fasciitis is a relatively common soft tissue tumor that exceeds in frequency. To compare the histopathology of nodular fasciitis nf with the magnetic resonance imaging mri findings in order to evaluate the basis of the mr signal characteristics. Wright columbia university, new york, ny changes in the uterus th h t lifthoughout life there are marked changes in the size of the uterus. When interpreting mr images of softtissue masses in adults, radiologists should be aware of the clinical behavior, common sites of occurrence, and histopathologic and imaging features of the common benign fibrous softtissue tumors. We present a case of eosinophilic fasciitis, or shulman syndrome, in a 35yearold man and discuss its clinical and histopathologic aspects, as well as its relationship to scleroderma. Embryology the endometrium and the myometrium are of mesodermal origin and are formed secondary to fusion of the mullerian paramesonephric ducts between the 8th and 9th postovulatory weeks. Webpathology is a free educational resource with 10236 high quality pathology images of benign and malignant neoplasms and related entities.
Dilated proliferativedilated proliferative type glands, with pseudostratification increased gland. To achieve this it is important that the tissue must be prepared in such a manner. Mri findings, available in all 10 patients, were compared with. Jan 11, 2018 proliferative fasciitis and proliferative myositis can look scary. The tissue undergoes a series of steps before it reaches the examiners desk to be thoroughly examined microscopically to arrive at a particular diagnosis. Eosinophilic fasciitis shulman syndrome mdedge dermatology. Characteristic mr imaging findings of proliferative myositis ji zhang1,xinhua bu1, weizhong tian1, jinhua chen1, xiulan wang1 1department of radiology, the peoples hospital of taizhou, taizhou medical school, yangzhou and nantong university, taizhou 225300, jiangsu province, china. Meijer introduction rhabdomyosarcoma rms is a soft tissue sarcoma which displays features of skeletal muscle differentia tion. Rapid involution of proliferative fasciitis springerlink.
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