Nuchal-type Fibroma
Brenda L. Nelson, DDS, MS
Lester D. R. Thompson, MD
Key Facts
Terminology
Benign, hyalinized, fibroblastic proliferation involving dermis and subcutis
Clinical Issues
Most common in posterior neck
Long history of superficial mass
Microscopic Pathology
Thick, haphazardly arranged collagen fibers
Unencapsulated with low cellularity
Entrapped adipose and skeletal muscle
Proliferation of peripheral nerves
Ancillary Tests
Positive: Vimentin, CD34, nuclear β-catenin
Top Differential Diagnoses
Elastofibroma, fibrolipoma, desmoid-type fibromatoses, nuchal fibrocartilaginous pseudotumor
 Hematoxylin & eosin shows a nuchal-type fibroma with thick, haphazardly arranged collagen fibers. Fat entrapment  is a highly reproducible and characteristic feature of NTFs. |
 This medium-power image shows a NTF with entrapment of adipose tissue  by the hypocellular fibrous stroma containing dense collagen bundles  . Note the scattered lymphocytes  . |
TERMINOLOGY
Abbreviations
Nuchal-type fibroma (NTF)
Synonyms
Nuchal fibroma
Terminology no longer technically correct since lesions may be found in areas other than posterior neck (though rarely)
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