Surgical Pathology Criteria

Desmoplastic Fibroblastoma

Differential Diagnosis

Fibromatosis, Abdominal Desmoid and Extra-abdominal Desmoid Desmoplastic Fibroblastoma
Mild to moderate cellularity Paucicellular
Moderate vascularity Hypovascular
Extensive infiltration of muscle Only focal muscle infiltration
Spindle cells usually in fascicular pattern Spindle and stellate cells randomly aranged

 

Desmoplastic Fibroblastoma Fibroma of Tendon Sheath
Wide distribution Most on hands or wrist
Single nodule Multilobular
Hypovascular Moderately vascular

 

Nuchal-type Fibroma Desmoplastic Fibroblastoma
Small cells with small nuclei Large cells with large nuclei
Poorly circumscribed Grossly well circumscribed

 

Desmoplastic Fibroblastoma Calcifying Fibrous Pseudotumor
No calcification Calcification present
Large stellate cells Small spindled cells
Inflammation uncommon Chronic inflammation present

 

Desmoplastic Fibroblastoma Nodular Fasciitis, Hyalinized
Paucicellular Moderately cellular areas
No mucin Cystic mucin pools, tissue tears
Lacks S and C shaped bundles of cells S and C shaped bundles of cells
Mitotic figures absent or rare Mitotic figures may be numerous

 

Low Grade Fibromyxoid Sarcoma Desmoplastic Fibroblastoma
Moderately cellular Paucicellular
Small nuclei, dense chromatin Large vesicular nuclei
Myxoid areas No myxoid areas
Whorled pattern No pattern

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