Surgical Pathology Criteria

Cellular Angiofibroma

Differential Diagnosis

The first four entities are predominantly perineal in location and may be confused with cellular angiofibroma

Angiomyofibroblastoma Cellular Angiofibroma
Alternating hypercellular and hypocellular areas Uniformly moderately cellular
Numerous small vessels Hyalinized round vessels
Clusters of rounded, epithelioid cells, often around vessels Bland spindle cells
Desmin positive most cases Desmin about 10% of cases
Numerous small vessels Large thick walled vessels
Actin frequently positive Actin infrequently positive
Both may have fat in lesion, both may be CD34+.

Aggressive Angiomyxoma Cellular Angiofibroma
Usually large, deep lesion Subcutaneous, mean size 6 cm
Hypocellular Moderately cellular
Infiltrative margin Circumscribed
Usually desmin positive Desmin 10% positive
May infiltrate fat May have fat integral to lesion
Both have prominent medium sized vessels, both may be CD34+.

Superficial Myofibroblastoma Cellular Angiofibroma
Desmin positive Desmin 10% positive
Inconspicuous thin walled vessels Prominent thick walled vessels
No fat Frequently contains fat
ER and PR >90% ER and PR 35-55%
Both are superficial and may be CD34 postive. Cellular angofibroma may occur in males.

Mammary-type Myofibroblastoma Cellular Angiofibroma
Bundles of hyalinized collagen Wispy collagen
Vessels inconspicuous Vessels prominent
Desmin and CD34 generally positive Desmin and CD34 variable
Both may contain adipose tissue

Cellular fibroma is virtually restricted to perineal, genital, inguinal regions, while the entities considered below may occur in a wide variety of sites.

Solitary Fibrous Tumor Cellular Angiofibroma
Alternating cellular and hypocellular areas Generally uniformly cellular
Staghorn vessels prominent Hyalinized round vessels prominent
Hyalinized collagen bundles frequent Wispy collagen frequent
CD34+ nearly all cases CD34+ 60% of cases

Spindle Cell Lipoma Cellular Angiofibroma
CD34+ nearly all cases CD34+ 60% of cases
Essentially restricted to neck, upper back Nearly all inguinal or perineal
Ropy collagen Wispy collagen
Inconspicuous vessels Prominent vessels

Schwannoma Cellular Angiofibroma
S100 positive S100 negative

Superficial Angiomyxoma Cellular Angiofibroma
Long thin walled vessels Hyalinized round vessels
Stromal neutrophils Usually stromal lymphocytes

Fibroepithelial Stromal Polyp Cellular Angiofibroma
Exophytic Sessile
May have scattered atypical stromal cells Uniform cells in most cases

Leiomyoma Cellular Angiofibroma
Desmin, actin uniformly positive Desmin, actin variable
Spindled cytoplasm Scant cytoplasm

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