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Dermatopathology Slide Review Part 158
Paul K. Shitabata, M.D.Dermatopathology Institute
Torrance, CA
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Nodular Fasciitis
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Notes
• Nodular fasciitis usually arises as a painful rapidly growing soft tissue tumor in the extremities and may have an antecedent history of trauma
• The characteristic “tissue culture” appearance of the myofibroblasts, brisk mitotic activity, and soft tissue location combined with the clinical history are helpful in arriving at the correct diagnosis
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Tissue culture-like appearance of myofibroblasts
Brisk mitotic rate but no atypical mitotic figres
Variable edema and chronic inflammation
Usually deep soft tissue location
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Leukocytoclastic vasculitis
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Must have fibrinoid necrosis of the vessels
Nuclear dust or hemorrhage insufficient for dx
May occasionally show bullous changes
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PAS stain
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Chromomycosis
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Medlar bodies (Sclerotic Bodies)
Often associated with splinter or foreign body
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Pigmented Spindle Cell Nevus
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Sharp peripheral circumscription
Pigmented spindled and epithelioid melanocytes
Minimal cytologic atypia
Kamino bodies rarely
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Malignant Melanoma in Situ,
Superficial Spreading
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Pleomorphic melanocytes with intraepithelial scatter
May have discohesive expansile junctional nests
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Recommended