Stanford School of Medicine
Surgical Pathology Criteria
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  • Fibrous mass characterized by beaded elastic fibers, generally infrascapular

Alternate / Historical Names

  • Elastofibroma dorsi
  • Elastofibroma scapulae

Diagnostic Criteria

  • Nearly always infrascapular
    • Located deep to latissimus dorsi and rhomboid muscles
    • Rarely reported from other sites including:
      • Foot, hand, arm
      • Lower back, neck
      • GI tract
  • Non-circumscribed, rubbery mass
    • Does not infiltrate muscle
  • Low power appearance is nondescript mixture of fibrous tissue and fat
    • Paucicellular
  • Diagnostic feature is coarsely beaded aggregates and strands of elastic tissue
    • Eosinophilic on H&E stain
    • Intensely positive on elastic stain

Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342

Original posting: November 20, 2007

Supplemental studies


CD34 100% positive, ranging from scant to abundant
Vimentin 100%
Factor XIIIa 100%


Calponin Negative
Desmin Negative
Actin and Smooth muscle actin Negative
S100 Negative

Differential diagnosis

  • Elastofibroma should be considered for any ill-defined mass of the posterior chest wall
  • Identification of coarse, beaded strands on elastic tissue stain is definitional


  • Nearly always over 55 years
  • Vast majority between chest wall and scapula
    • Located deep to latissimus dorsi and rhomboid muscles
    • Rarely reported from other sites including:
      • Foot, hand, arm
      • Lower back, neck
      • GI tract
  • Slowly growing
  • Markedly increased incidence in Okinawa
    • Some cases familial in Okinawa
  • Cured by excision


Soft tissue "fibromas"


  • Kempson RL, Fletcher CDM, Evans HL, Henrickson MR, Sibley RS. Tumors of the Soft Tissues, Atlas of Tumor Pathology, AFIP Third Series, Fascicle 30, 2001
  • Fletcher CDM, Unni KK, Mertens F. Pathology and Genetics of Tumours of Soft Tissue and Bone, World Health Organization Classification of Tumours 2002
  • Weiss SW, Goldblum JR. Enzinger and Weiss's Soft Tissue Tumors, 4th edition, 2001
  • Nagamine N, Nohara Y, Ito E.  Elastofibroma in Okinawa. A clinicopathologic study of 170 cases.  Cancer 1982 Nov 1;50(9):1794-805
  • Kindblom LG, Spicer SS.  Elastofibroma. A correlated light and electron microscopic study.  Virchows Arch A Pathol Anat Histol 1982;396(2):127-40
  • Hisaoka M, Hashimoto H. Elastofibroma: clonal fibrous proliferation with predominant CD34-positive cells. Virchows Arch. 2006 Feb;448(2):195-9.
  • Gun BD, Bahadir B, Behzatoglu K, Gun MO, Ozdamar SO. Elastofibroma: a clinicopathologic and immunohistochemical study of seven cases and literature review.
    APMIS. 2007 Feb;115(2):115-9.
  • Yamazaki K. An ultrastructural and immunohistochemical study of elastofibroma: CD 34, MEF-2, prominin 2 (CD133), and factor XIIIa-positive proliferating fibroblastic stromal cells connected by Cx43-type gap junctions. Ultrastruct Pathol. 2007 May-Jun;31(3):209-19.
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