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RESIDENT
CASE
STUDIES
September 25,
2003: Case 1 Table
of Contents | List
of Diagnoses | Case 1 | Case 2 |
Case
3 | Case 4 | Case
5
71 year old female with a scapula mass
Discussion by Erin Thibault, MD
Elastofibroma is a fibrous reactive process
that exhibits abnormal elastogenesis. These almost
always occur in the soft tissue around the scapula and present as a slowly
growing, deep-seated mass that only rarely causes pain or tenderness.
Distribution: Older than 55 years of
age
Gross Appearance: Gray-white,
rubbery mass which is ill-defined and may contain yellow streaks of
elastin. Usually ranges in size from 5-10cm.
Microscopic
Appearance:
- Paucicellular, hyalinized stroma which
contains large, coarse, pale eosinophilic collagen and elastic fibers
- The elastic fibers may appear like globules
which are linearly arranged--"beads on a string"
- May contain focal areas of myxoid stroma
or trapped residual fat
Diagnostic Criteria
- Paucicellular
- Abnormal elastic fibers
- Hyalinized stroma
Immunostains:
- Elastic stains show these fibers (20 -
30 um) very well.
Differential Diagnosis:
- Nuchal fibroma
- Fibrolipoma
- Desmoid fibromatosis
References:
- Kempson et al. : AFIP Atlas of Tumor
Pathology, Tumors of the Soft Tissues, Volume 30, Third series.
- Stephen S Sternberg et al. (Eds): Diagnostic surgical pathology, Volume 1, 3rd edition. Lippincott William & Wilkins.
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