Palmar Fibromatosis
Differential Diagnosis
- Calcifying aponeurotic fibroma
- Extra-abdominal desmoid fibromatosis
- Fibrosarcoma
- Synovial sarcoma
- Epithelioid sarcoma
- Inclusion body fibromatosis
Palmar or Plantar Fibromatosis | Calcifying Aponeurotic Fibroma |
---|---|
Rare under 20 | Predominantly <20 |
Not calcified | Calcified |
Rarely chondroid | Chondroid |
No muscle or nerve infiltration | May infiltrate muscle and nerve |
Extra-abdominal Desmoid Fibromatosis | Palmar and Plantar Fibromatosis |
---|---|
Rare on hands and feet | Occurs on hands and feet |
Primarily one large mass | Multiple small nodules |
Infiltrates muscle | No muscle infiltration |
Palmar or Plantar Fibromatosis | Adult Fibrosarcoma |
---|---|
Occurs in hands | Rare in hands |
Multiple small nodules | Single large mass |
Involves fascia | Deep to fascia |
Haphazard pattern | Herringbone pattern |
Cytologically bland | Cytologically atypical |
No atypical mitotic figures | Atypical mitotic figures may be seen |
Rarely necrotic | Frequent necrosis |
Palmar or Plantar Fibromatosis | Synovial Sarcoma |
---|---|
Rare under age 20 | Frequently under age 20 |
Multiple small nodules | Single large mass |
Not biphasic | May be biphasic |
Variable cellularity | Uniformly hypercellular |
Lacks ropy collagen, calcification and stag horn vessels | May have ropy collagen, calcification and stag horn vessels |
No SYT-SSX fusion | SYT-SSX fusion present |
Palmar or Plantar Fibromatosis | Epithelioid Sarcoma |
---|---|
Necrosis absent | Necrosis common |
No epithelioid cells | Epithelioid cells present |
Cytologicially bland | Cytologically atypical |
Keratin negative | Keratin positive |
CD34 negative | CD34 50% positive |
Palmar or Plantar Fibromatosis | Inclusion Body Fibromatosis |
---|---|
Usually in palm or sole | Usually on digits |
Uncommon in children | Vast majority very young |
No inclusions | Inclusions |