Elastofibroma
Cyril Fisher, MD, DSc, FRCPath
Key Facts
Terminology
Pseudotumor composed of fragmented abnormal elastic fibers in collagenous stroma
Etiology/Pathogenesis
Probably related to trauma or friction
Clinical Issues
History of manual labor in some cases
Mostly over 50 years
Female predominance
Typically at inferior margin of scapula on chest wall
Rarely in other locations
Microscopic Pathology
Infiltrative, ill-defined lesion
Numerous thickened and fragmented elastic fibers
Sparse, scattered, bland spindle cells
Dense collagenous stroma
Infiltrates fat, skeletal muscle
 Gross photograph shows a firm white tumor with irregularly infiltrating fat. This formed a firm plaque in the subscapular region; the plaque had been present and slowly enlarging for several years. |
 Elastic van Gieson shows elastic fibers at high magnification. Note the “string of beads” appearance with aggregated or separated, variably sized, rounded fragments of black-staining elastic material. |
TERMINOLOGY
Synonyms
Elastofibroma dorsi
Definitions
Pseudotumor composed of fragmented abnormal elastic fibers in collagenous stroma
ETIOLOGY/PATHOGENESIS
Environmental Exposure
Some related to trauma or friction
Some cases reported in manual workers doing repetitive physical labor
Similar microscopic changes are found in 15% of autopsies of older patients
Genetic Predisposition
Some cases familial
Examples occur in visceral locations
Possibly formation of abnormal elastic fibers
CLINICAL ISSUES
Epidemiology
Incidence
Rare
Occasionally bilateral
Increased incidence in Okinawa, Japan
Some familial, genetic component
Age
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