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Case 119 - Discussion

Uploaded: 2010-07-04, Updated: 2010-07-04

 

Palisaded Myofibroblastoma

  • Mostly inguinal lymph node, solitary and painless

  • Benign, rarely recurs

  • Micro:

    • Palisading spindle cells, no nuclear atypia, rare mitoses

    • Amianthoid bodies:  homogeneous eosinophilic collagen deposit, fine hair-like spokes, peripheral granular weakly eosinophilic area. Trichrome stain +

    • Hemorrhage, hemosiderin deposit

  • IPX: SMA+, myosin+,  vimentin+; desmin-, Factor VIII -, S100-, synaptophysin-

  • DDX:

    • Kaposi sarcoma: no Amianthoid bodies, but shows endothelial clefts, RBC extravasculation, inflammatory cells, and HHV8+

    • Schwannoma: no Amianthoid bodies, but shows Antoni A and B patterns, thick-walled vessels, and S100+

    • Spindle cell sarcoma: atypia, mitosis and lack of Amianthoid bodies

Reference:

  • Ioachim's Lymph Node Pathology, 4th edition