Fibroblastic and myofibroblastic tumors

Fibroblastic and myofibroblastic tumors
Pathology revealed a proliferation of plump and spindle fibroblasts, consistent with nodular fasciitis
SpecialtyPathology, Dermatology, General surgery, Oncology, Surgical oncology
TypesBenign, locally invasive, rarely metastasizing, malignant

Fibroblastic and myofibroblastic tumors (FMTs) develop from the mesenchymal stem cells which differentiate into fibroblasts (the most common cell type in connective tissue) and/or the myocytes/myoblasts that differentiate into muscle cells. FMTs are a heterogeneous group of soft tissue neoplasms (i.e. abnormal and excessive tissue growths). The World Health Organization (2020) defined tumors as being FMTs based on their morphology and, more importantly, newly discovered abnormalities in the expression levels of key gene products made by these tumors' neoplastic cells.[1] Histopathologically, FMTs consist of neoplastic connective tissue cells which have differented into cells that have microscopic appearances resembling fibroblasts and/or myofibroblasts. The fibroblastic cells are characterized as spindle-shaped cells with inconspicuous nucleoli that express vimentin, an intracellular protein typically found in mesenchymal cells, and CD34, a cell surface membrane glycoprotein. Myofibroblastic cells are plumper with more abundant cytoplasm and more prominent nucleoli; they express smooth muscle marker proteins such as smooth muscle actins, desmin, and caldesmon.[2] The World Health organization further classified FMTs into four tumor forms based on their varying levels of aggressiveness: benign, intermediate (locally aggressive), intermediate (rarely metastasizing), and malignant.[1]

Forms

Benign FMTs

Intermediate (locally aggressive) FMTs

Intermediate (rarely metastasizing) FMTs

Malignant FMTs

See also

References

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