| BACKGROUND: Nodular fasciitis is a benign, fibrohistiocytic tumor most commonly arising on the trunk. Histopathologically it can be misdiagnosed as a sarcoma. OBJECTIVE: To describe a case of nodular fasciitis on the forehead and to review the clinical and histologic characteristics of the tumor. methods: Case report and review of the literature. RESULTS: Local excision to completely remove tumor has proven curative at 1 year of follow-up. CONCLUSION: Nodular fasciitis can be encountered on the head and neck and should be regarded as a benign tumor. Either minimal excision or even a "watch and wait" plan can be successful in treating this tumor. ( info) |
2/528. Nodular fasciitis: response to intralesional corticosteroids. Nodular fasciitis is one of the more common soft-tissue lesions, frequently presenting as a rapidly enlarging subcutaneous mass on the arm. Management is usually surgical excision; however, large infiltrative lesions may be difficult to manage. We describe a patient in whom intralesional corticosteroid injections provided rapid resolution. ( info) |
3/528. Atypical decubital fibroplasia associated with bizarre parosteal osteochondromatous proliferation (Nora's reaction). We describe recurring bizarre parosteal osteochondromatous proliferation (Nora's reaction) associated with atypical decubital fibroplasia in the region of the greater trochanter of the femur in a 52-year-old man. We hypothesize that these two recently introduced entities may represent two forms of tissue response to injury (ischemia) inducing proliferative reaction of bone and cartilage in the vicinity of periosteum, and necroses with hyperplastic granulation tissue and myxoid stroma in the subcutaneous tissues. ( info) |
4/528. Nodular fasciitis of the lower eyelid in a pediatric patient. PURPOSE: To describe a 14-year-old boy with a 1-month history of a rapidly growing, nontender, lower eyelid mass. methods: The specimen was studied using light microscopy. RESULTS: Although magnetic resonance imaging suggested a chronic vascular lesion, histopathologic analysis after excisional biopsy was consistent with nodular fasciitis. CONCLUSIONS: Nodular fasciitis is a relatively common soft-tissue lesion and represents a benign, reactive process. Lesions in the head and neck develop more frequently in children and adolescents than in adults, but periorbital lesions are uncommon. This is the first reported case of nodular fasciitis of the lower eyelid in a pediatric patient. ( info) |
5/528. Intravascular fasciitis of the forearm vein: a case report with immunohistochemical characterization. Intravascular fasciitis is a very unusual variant of nodular fasciitis. A unique case of this lesion occurring in the proximal portion of the superficial vein of the forearm in an otherwise healthy 26-year-old man is reported. The intravascular polypoid lesion grew longitudinally along the vascular lumen, was loosely attached to the intimal layer, and was partly anchored beyond the internal elastic lamina into the medial smooth muscle layer. However, extravascular involvement was absent. The histological features were identical to those observed in ordinary cellular nodular fasciitis. Because of its myofibroblastic phenotype exhibited by highly proliferative spindle cells, certain intimomedial myofibroblasts are thought to be the indigenous source of this unique fibroproliferative lesion. Unless the diagnosis of intravascular fasciitis is considered and appropriate differential markers examined, it may be confused with other intravascular lesions, such as intravascular leiomyoma, intravenous pyogenic granuloma, organized thrombus and, even, fibromuscular dysplasia if it arises in the arteries. A simple excision is considered curable. Even so, two recurrent cases have been documented to date. ( info) |
6/528. Papillary thyroid carcinoma with nodular fasciitis-like stroma. Pitfalls in fine-needle aspiration cytology. Papillary thyroid carcinoma with nodular fasciitis-like stroma is one of the rare variants of papillary thyroid carcinoma. The problems posed by the exuberant nodular fasciitis-like stroma, which obscures the neoplastic nature of the tumor, are recognized in surgical pathology but have received little attention in the cytopathology literature. We report a rare case of papillary thyroid carcinoma in which nodular fasciitis-like stroma posed difficulty on fine-needle aspiration cytology. The differential diagnosis of fibroproliferative processes in thyroid fine-needle aspirations is also discussed. ( info) |
7/528. kidney involvement in a 17-year-old boy with eosinophilic fasciitis. Eosinophilic fasciitis (EF) is characterized by symmetrical scleroderma-like induration of skin over one or more distal extremities, peripheral eosinophilia, absence of Raynaud phenomenon and visceral involvement and a favourable response to systemically administered corticosteroids. Like other scleroderma-like disorders EF is rarely described in children. We report renal involvement in a 17-year-old boy with EF. urinalysis disclosed proteinuria. Prior to corticosteroid therapy renal biopsy was performed which revealed ischemic collapse of glomerular capillaries and atrophy of tubules of the cortex. Electron-microscopic studies showed hyperplasia of the renin-producing epitheloid cells in the juxtaglomerular apparatus. Few other publications have depicted renal involvement in EF of quite different character. In these cases renal biopsy and histological classification is warranted because of prognostic and therapeutic implications. ( info) |
8/528. Cranial fasciitis in an adult: CT and MR imaging findings. Cranial fasciitis is a rare bone lesion in childhood. We report the first case in an adult, with CT and MR imaging, and suggest some diagnostic keys. ( info) |
9/528. Lymph-node-based malignant lymphoma and reactive lymphadenopathy in eosinophilic fasciitis. BACKGROUND: Lymph node enlargement in patients with eosinophilic fasciitis is a rare occurrence and its clinical significance is unknown. methods: The literature and authors' registries were searched for eosinophilic fasciitis associated with lymphadenopathy. Clinical data, time sequence of appearance of either disorder, and pathological diagnoses were analyzed. RESULTS: Six patients presenting with eosinophilic fasciitis had a lymph-node-based lymphoma and 4 patients had a reactive lymphadenopathy. The patients with lymphoma were elderly and the subcutaneous induration preceded the lymphadenopathy by 2 to 36 months. The patients with eosinophilic fasciitis and reactive lymphadenopathy were young and the onset of subcutaneous induration and lymph node enlargement coincided with one another. Favorable response of the eosinophilic fasciitis to prednisone therapy was attained in 3 of 3 patients with reactive lymphadenopathy and in 4 of the 6 cases with lymphoma. CONCLUSIONS: Eosinophilic fasciitis is rarely associated with clinically significant lymph node enlargement. Subcutaneous induration preceding the lymphadenopathy by 6 months or more, especially in elderly patients, suggests an underlying lymphoma. A favorable response of the subcutaneous induration to prednisone treatment does not exclude the diagnosis of lymphoma; therefore, it does not supersede the need of a pathological evaluation. A lymph node biopsy is mandatory in all cases. ( info) |
10/528. Papillary thyroid carcinoma with exuberant nodular fasciitis-like stroma in a fine needle aspirate. A case report. BACKGROUND: Papillary thyroid carcinoma (PTC) with exuberant nodular fasciitis-like stroma (PTC-ES) is a new morphologic variant of conventional PTC. It is characterized by extensive reactive stromal proliferation, which may occupy 60-80% of the tumor. CASE: A 42-year-old female developed a tender, left-sided thyroid mass. The fine needle aspiration biopsy specimen contained, besides diagnostic epithelial features of PTC, many cohesive tissue fragments of cellular stroma. CONCLUSION: A correct cytopathologic diagnosis of PTC-ES can be established if both epithelial and stromal components are present in needle aspirates. ( info) |