Surgical Pathology Criteria

Myofibroma, Solitary and Multicentric

Differential Diagnosis

 

Infantile hemangiopericytoma
We consider this to be the same tumor as myofibroma

 

Glomangiopericytoma and myopericytoma It has been proposed that these two tumors and myofibroma are part of the same spectrum
Myofibroma Glomangiopericytoma and Myopericytoma
Small primitive cells present Lacks small primitive component
Lacks perivascular pattern Perivascular distribution
Some overlap may occur

 

Myofibroma Inflammatory Myofibroblastic Tumor
90% <2 years Usually age 0-14 years
Biphasic nodules with immature cells No immature cells
Hemangiopericytomatous vessels No HPC like vessels
Rare in abdomen Frequent in abdomen

 

Myofibroma Infantile Fibrosarcoma
Random spindle cell pattern Fascicular pattern
Biphasic mature and immature areas No biphasic pattern
Atypical mitotic figures rare Atypical mitotic figures common

 

Solitary Fibrous Tumor Myofibroma
Lacks biphasic nodular pattern Biphasic nodular pattern
CD34 >95% positive CD34 negative
Actin focal, rare Actin positive
Multiple lesions uncommon 25% of cases multifocal
Rare in infants Rare over age 2 years
Both frequently show a hemangiopericytoma-like vascular pattern

 

Hemangiopericytoma Myofibroma
Rare under age 20 years Rare over age 2 years
Lacks biphasic nodular pattern Biphasic nodular pattern
CD34 50% positive CD34 negative
Actin focal, rare Actin positive
Multiple lesions uncommon 25% of cases multifocal
Both frequently show a hemangiopericytoma-like vascular pattern

 

Leiomyoma Myofibroma
Lacks biphasic pattern Biphasic nodular pattern
Lacks HPC-like vascular pattern Frequent HPC-like vascular pattern
Multiple lesions uncommon 25% of cases multifocal
Desmin variable Desmin negative

 

Nodular Fasciitis Myofibroma
Lacks biphasic pattern Biphasic nodular pattern
Lacks HPC-like vascular pattern Frequent HPC-like vascular pattern
Multiple lesions rare 25% of cases multifocal
Desmin variable Desmin negative

 

Fibrous Hamartoma of Infancy Myofibroma
Triphasic lesion with spindle cell fibrous areas, adipose tissue and clusters of immature mesenchymal cells Biphasic lesion with outer spindled cells and inner immature cells
Lacks hemangiopericytomatous vessels Hemangiopericytoma-like vessels frequent

 

Myofibroma Inclusion Body Fibromatosis
Rare on digits Usually on digits
Biphasic nodules with central primitive cells Lacks primitive cells and perivascular clustering of cells
No inclusions Inclusions

 

Myofibroma Plexifiorm Fibrohistiocytic Tumor
Circumscribed Plexiform rays infiltrate fat
Central primitive dark cells with hemangiopericytoma-like vessels Nodules with histiocyte-like cells and multinucleated cells

Lesions that may demonstrate a prominent hemangiopericytoma-like vascular pattern

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