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Giant pelvic angiomyofibroblastoma: case report and literature review.

Qiu P, Wang Z, Li Y, Cui G - Diagn Pathol (2014)

Bottom Line: Most AMFs and aggressive angiomyxomas have the same immunohistochemical phenotype.The well-circumscribed borders of AMF are the most important characteristic that distinguish it from aggressive angiomyxomas.AMFs rarely recur after complete surgical excision.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Endocrinology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 610500, People's Republic of China. 421051947@qq.com.

ABSTRACT

Unlabelled: Angiomyofibroblastoma (AMF) is a rare, benign, soft-tissue tumor, which predominantly occurs in the vulvovaginal region of middle-aged women. It is clinically important to distinguish an AMF from other stromal cell lesions. Here, we report the case of a 32-year-old woman with a rare, giant pelvic AMF, which showed a benign clinical course. The tumor was located in the cul-de-sac of Douglas. It was well demarcated, hypocellular, edematous and composed of spindle-shaped and oval stromal cells aggregating around thin-walled blood vessels. The tumor cells had abundant eosinophilic cytoplasm, and expressed estrogen receptors, progesterone receptors and desmin. Mitotic figures were absent. It is important to distinguish AMFs from aggressive angiomyxomas because both occur at similar sites but show different clinical behaviors. Most AMFs and aggressive angiomyxomas have the same immunohistochemical phenotype. The well-circumscribed borders of AMF are the most important characteristic that distinguish it from aggressive angiomyxomas. AMFs rarely recur after complete surgical excision.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5510813471244189.

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Histopathological examination of tumor post-operation. (a) The tumor is well demarcated from the surrounding fat tissues. (b) Abundant thin-walled blood vessels can be seen in the tumor. (c) The stroma of the tumor is hyalinized or edematous, and appears hypocellular in some areas. (d) The tumor is composed of bland, plump, spindle-shaped or oval cells that are frequently aggregated around thin-walled blood vessels (H&E: 100 x).
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Figure 2: Histopathological examination of tumor post-operation. (a) The tumor is well demarcated from the surrounding fat tissues. (b) Abundant thin-walled blood vessels can be seen in the tumor. (c) The stroma of the tumor is hyalinized or edematous, and appears hypocellular in some areas. (d) The tumor is composed of bland, plump, spindle-shaped or oval cells that are frequently aggregated around thin-walled blood vessels (H&E: 100 x).

Mentions: The excised tumor was well circumscribed and measured 10 × 6 × 5 cm. The cut surface appeared tan in color and homogeneous with large flesh-like tissue. No hemorrhage, necrosis or cystic changes were observed. Under a microscope, the tumor appeared well demarcated from the surrounding fat tissue (Figure 2a), and was characterized by alternating hypercellular and hypocellular edematous zones in which abundant thin-walled blood vessels were haphazardly distributed (Figure 2b). The stroma of the tumor appeared hyalinized or edematous and was hypocellular in some areas (Figure 2c). Interstitial myxoid degeneration was also seen in the lesion. The tumor cells were spindle-shaped or stellate, with fine chromatin and inconspicuous nucleoli (Figure 2d). Mitotic figures were absent. Bland-looking myoid tumor cells were scattered in the fibromxyoid stroma, and sometimes aggregated around the blood vessels. Immunohistochemistry (IHC) revealed that the tumor cells were positive for desmin (Figure 3a), estrogen receptor (Figure 3b), progesterone receptor (Figure 3c) and vimentin; the Ki-67 proliferation index was less than 5% (Figure 3d). The tumor was negative for smooth muscle actin, S-100 protein, CD34, CD117 and β-catenin. These distinctive pathological and IHC features indicated a diagnosis of AMF.


Giant pelvic angiomyofibroblastoma: case report and literature review.

Qiu P, Wang Z, Li Y, Cui G - Diagn Pathol (2014)

Histopathological examination of tumor post-operation. (a) The tumor is well demarcated from the surrounding fat tissues. (b) Abundant thin-walled blood vessels can be seen in the tumor. (c) The stroma of the tumor is hyalinized or edematous, and appears hypocellular in some areas. (d) The tumor is composed of bland, plump, spindle-shaped or oval cells that are frequently aggregated around thin-walled blood vessels (H&E: 100 x).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4066829&req=5

Figure 2: Histopathological examination of tumor post-operation. (a) The tumor is well demarcated from the surrounding fat tissues. (b) Abundant thin-walled blood vessels can be seen in the tumor. (c) The stroma of the tumor is hyalinized or edematous, and appears hypocellular in some areas. (d) The tumor is composed of bland, plump, spindle-shaped or oval cells that are frequently aggregated around thin-walled blood vessels (H&E: 100 x).
Mentions: The excised tumor was well circumscribed and measured 10 × 6 × 5 cm. The cut surface appeared tan in color and homogeneous with large flesh-like tissue. No hemorrhage, necrosis or cystic changes were observed. Under a microscope, the tumor appeared well demarcated from the surrounding fat tissue (Figure 2a), and was characterized by alternating hypercellular and hypocellular edematous zones in which abundant thin-walled blood vessels were haphazardly distributed (Figure 2b). The stroma of the tumor appeared hyalinized or edematous and was hypocellular in some areas (Figure 2c). Interstitial myxoid degeneration was also seen in the lesion. The tumor cells were spindle-shaped or stellate, with fine chromatin and inconspicuous nucleoli (Figure 2d). Mitotic figures were absent. Bland-looking myoid tumor cells were scattered in the fibromxyoid stroma, and sometimes aggregated around the blood vessels. Immunohistochemistry (IHC) revealed that the tumor cells were positive for desmin (Figure 3a), estrogen receptor (Figure 3b), progesterone receptor (Figure 3c) and vimentin; the Ki-67 proliferation index was less than 5% (Figure 3d). The tumor was negative for smooth muscle actin, S-100 protein, CD34, CD117 and β-catenin. These distinctive pathological and IHC features indicated a diagnosis of AMF.

Bottom Line: Most AMFs and aggressive angiomyxomas have the same immunohistochemical phenotype.The well-circumscribed borders of AMF are the most important characteristic that distinguish it from aggressive angiomyxomas.AMFs rarely recur after complete surgical excision.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Endocrinology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 610500, People's Republic of China. 421051947@qq.com.

ABSTRACT

Unlabelled: Angiomyofibroblastoma (AMF) is a rare, benign, soft-tissue tumor, which predominantly occurs in the vulvovaginal region of middle-aged women. It is clinically important to distinguish an AMF from other stromal cell lesions. Here, we report the case of a 32-year-old woman with a rare, giant pelvic AMF, which showed a benign clinical course. The tumor was located in the cul-de-sac of Douglas. It was well demarcated, hypocellular, edematous and composed of spindle-shaped and oval stromal cells aggregating around thin-walled blood vessels. The tumor cells had abundant eosinophilic cytoplasm, and expressed estrogen receptors, progesterone receptors and desmin. Mitotic figures were absent. It is important to distinguish AMFs from aggressive angiomyxomas because both occur at similar sites but show different clinical behaviors. Most AMFs and aggressive angiomyxomas have the same immunohistochemical phenotype. The well-circumscribed borders of AMF are the most important characteristic that distinguish it from aggressive angiomyxomas. AMFs rarely recur after complete surgical excision.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5510813471244189.

Show MeSH
Related in: MedlinePlus