Sclerotic Fibroma

 Typically does not show prominent storiforming of collagen, although it may be focally present in rare cases



• Pleomorphic fibroma
image Pleomorphic cells are more prominent, and storiforming pattern of collagen should be absent

• Collagenous fibroma
image Densely collagenous or fibromyxoid stroma; lacks prominent storiforming of collagen

• Acral fibrokeratoma (subungual and periungual fibroma)
image Usually shows overlying hyperkeratosis and acanthosis



image
Sclerotic Fibroma at Scanning Magnification
Scanning magnification view shows a dermal-based nodular fibroblastic proliferation with storiforming of collagen.


image
Sclerotic Fibroma With Storiforming Collagen
Higher magnification of the lesion shows prominent areas of storiforming collagen bundles separated by small clefts image, imparting a typical plywood-like pattern.

image
Inflamed and Traumatized Sclerotic Fibroma
This lesion showed overlying evidence of trauma and mixed, predominantly lymphocytic inflammation in the dermis. However, there are sclerotic collagen bundles image with clefts and a vaguely storiforming appearance.

image
FXIIIA Immunohistochemistry in Sclerotic Fibroma
FXIIIA immunohistochemistry shows staining of scattered spindle cells image.


TERMINOLOGY


Synonyms




• Storiform collagenoma

• Pleomorphic sclerotic fibroma


Definitions




• Benign, dermal-based fibroblastic proliferation with storiforming bundles of collagen


ETIOLOGY/PATHOGENESIS


Unknown




• May be related to trauma

• Some cases may represent regressed dermatofibromas


Genetic Syndrome




• Multiple lesions are associated with Cowden syndrome, consistent with genetic influence


CLINICAL ISSUES


Epidemiology




• Age
image May occur at any age, including in infants and elderly

• Sex
image Roughly equal incidence in male and female patients


Site




• Presents most commonly on face, extremities, and trunk

Apr 24, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Sclerotic Fibroma
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