NEURAL, FAT AND FIBROUS TUMOR

Question 1

Answer 1

NEUROFIBROMA

• Not encapsulated
• Spindle cells with elongated, sometimes wavy nuclei
• Mast cells
• S100 positive

Question 2

Answer 2

Neurofibroma

Question 3

Answer 3

Question 4

Answer 4

Question 5

Answer 5

Schwannoma

Question 6

Answer 6

SMOOTH MUSCLE TUMOR: LEIOMYOMA

• Unencapsulated, intradermal tumor
• Interlacing and sometimes whorled bundles of smooth muscle cells
• Eosinophilic cytoplasm with blunt nuclear ends (cigar shaped)
• Special stain: Trichrome (red)
• IHC: Desmin

Question 7

Smooth muscle special stain

Answer 7

Trichrome Stain

Question 8

Answer 8

Question 9

Answer 9

Question 10

Answer 10

FIBROUS TUMOR: HYPERTROPHIC SCAR

• Nodular, whorled masses
• More cellular than keloid
• Vertically aligned vessels

Question 11

Answer 11

FIBROUS TUMOR: HYPERTROPHIC SCAR

Question 12

Answer 12

Question 13

Answer 13

FIBROUS TUMOR: KELOID

Question 14

Answer 14

FIBROUS TUMOR: FIBROEPITHELIAL POLYP(ACROCHORDON)

• Epidermis: may be hyperplastic and papillomatous, surrounding core of fibrovascular tissue
• Loose fibrocollagenous stroma

Question 15

Answer 15

FIBROUS TUMOR: DERMATOFIBROMA (FIBROUS HISTIOCYTOMA)

• Hyperplastic epidermis with basal layer hyperpigmentation
• Rounding up of collagen bundles (collagen balls)
• Fibroblast-like spindle cells, histiocytes and blood vessels in varying proportions
• Factor XIIIa positive

Question 16

How can you differentiate dermatofibroma from DFSP?

Answer 16

Factor XIIIa (+), CD34 (-)

Question 17

Answer 17

FIBROUS TUMOR: DERMATOFIBROMA

Question 18

Answer 18

Question 19

Answer 19

FIBROUS TUMOR: DERMATOFIBROSARCOMA PROTUBERANS

Question 20

• What is the diagnosis?
• Associated syndrome?

Answer 20

• Plexiform neurofibroma
• NF Type I

Question 21

• What is the diagnosis?
• IHC Stain?

Answer 21

Dermatofibroma
Factor XIIIa

Question 22

• What is the diagnosis?
• What is the area of highlighted cells called?

Answer 22

Schwannoma
Antoni B

Question 23

Answer 23

Leiomyoma
Masson’s Trichrome stain

Question 24

Answer 24

Neurofibroma
Mast cell

Question 25

1. Diagnosis 2. Associated conditions with this lesion

Answer 25

ANGIOFIBROMA Seen in: -Tuberous sclerosis -Fibrous papule of the face -Pearly penile papules

Question 26

What kind of tumors are Hypertrophic scar and keloid?

Answer 26

Fibroblastic/ Fibrous Tumors

Question 27

Answer 27

Keloid

Question 29

Answer 29

FIBROUS TUMOR: ANGIOFIBROMA

Question 30

Answer 30

ADIPOCYTIC TUMOR: FIBROLIPOMA * Strands of collagenous, fibrous connective tissue within mature adipocytes

Question 31

Answer 31

Question 32

Smooth muscle IHC

Answer 32

Desmin

Question 33

Identify

Answer 33

Nerve

Question 34

Identify

Answer 34

Smooth muscle

Question 35

Identify

Answer 35

collagen

Question 36

Answer 36

* Encapsulated * Capillaries and larger caliber vessels containing characteristic microthrombi * Vessels constitute 5 to 50% of the tumor ## Footnote *noted microthrombi in the photo