Announcing the new book by DermNet NZ

Download a FREE sample chapter

DOWNLOAD NOW

Nodular fasciitis pathology

Author: Assoc Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand, 2013.

Nodular fasciitis presents as a rapidly growing soft tissue mass which may follow a history of trauma.

Histology of nodular fasciitis

Low power examination of nodular fasciitis shows a well-circumscribed discrete mass in the subcutaneous adipose tissue (figure 1). Dermal and intravascular forms have also been described.

The tumour is composed of haphazardly arranged mass of spindled and plump cells which is often compared to tissue culture. The cells are set in a fibromyxoid stroma. Some typical mitoses are commonly seen. There may be numerous red blood cells (figure 2), and chronic inflammatory cells. Proliferative fasciitis is a well recognized variant and is composed of epithelioid cells which resemble ganglion cells (figure 3).

Special studies for nodular fasciitis

The myofibroblasts are positive with smooth muscle actin, calponin. Desmin and S100 are negative

Differential diagnosis of nodular fasciitis

Sarcoma – Atypical mitoses, tumour necrosis and frank nuclear atypia are unusual in nodular fasciitis and suggest a malignant process. Low grade sarcomas (such as low grade fibromyxoid tumour) may cause diagnostic difficulty but generally do not exhibit the tissue culture-like disorganized array of myofibroblasts.

Related information

Make a donation

Donate Today

Help us to update and maintain DermNet New Zealand

Submit your images

We are expanding our image library

Contact us

History of DermNet NZ

Watch Dr Amanda Oakley presenting 'The History Of DermNet NZ' at The International Society Of Teledermatology.

Subscribe to our mailing list

* indicates required
DermNet NZ Newsletter