Fibroma pathophysiology

Revision as of 18:49, 26 February 2016 by Simrat Sarai (talk | contribs)
Jump to navigation Jump to search

Fibroma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Screening

Differentiating Fibroma from other Diseases

Natural History, Complications & Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Case Studies

Case #1

Fibroma pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Fibroma pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Fibroma pathophysiology

CDC on Fibroma pathophysiology

Fibroma pathophysiology in the news

Blogs on Fibroma pathophysiology

Directions to Hospitals Treating Fibroma

Risk calculators and risk factors for Fibroma pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

On gross pathology, solid white mass which is usually well-circumscribed is characteristic findings of ovarian fibroma. On microscopic histopathological analysis, ovarian fibroma is composed of spindle cells forming variable amounts of collagen. Sectioning of a fibroma typically reveals a chalky-white surface that has a whorled appearance, similar to that of a uterine fibroid. Areas of edema, occasionally with cyst formation, are also relatively common. On gross pathology, polypoid lesion which is usually small, is characteristic findings of oral fibroma. On microscopic histopathological analysis, fibrous stroma, collagen bundles, prominent vessels, and overlying squamous mucosa with hyperkeratosis and focal ulceration are characteristic findings of oral fibroma. On gross pathology, well circumscribed, metaphyseal lesion, and fragments of white-grey rubbery tissue are characteristic findings of chondromyxoid fibroma. On microscopic histopathological analysis, spindle cells or stellate cells in a myxoid or chondroid stroma, lobules with hypocellular centers and hypercellular peripheries, giant cells in a hypercellular periphery, and scattered calcifications are characteristic findings of chondromyxoid fibroma.

Pathophysiology

Ovarian Fibroma

Gross Pathology

On gross pathology, solid white mass which is usually well-circumscribed is characteristic findings of ovarian fibroma.

Microscopic Pathology

On microscopic histopathological analysis, fibroma is composed of spindle cells forming variable amounts of collagen. Sectioning of a fibroma typically reveals a chalky-white surface that has a whorled appearance, similar to that of a uterine fibroid. Areas of edema, occasionally with cyst formation, are also relatively common.

Oral Fibroma

Gross Pathology

On gross pathology, polypoid lesion which is usually small, is characteristic findings of oral fibroma.

Microscopic Pathology

Following features are noted on microscopic histopathological analysis of oral fibroma:

  • Fibrous stroma is a key feature
  • Collagen bundles may be present
  • Vessels may be prominent
  • Overlying squamous mucosa is benign
    • Hyperkeratosis may be present
    • Focal ulceration may be present

Chondromyxoid Fibroma

Gross Pathology

On gross pathology, well circumscribed, metaphyseal lesion, and fragments of white-grey rubbery tissue are characteristic findings of chondromyxoid fibroma.

Microscopic Pathology

Following features are noted on microscopic histopathological analysis of chondromyxoid fibroma:

  • Spindle cells or stellate cells in a myxoid or chondroid stroma
  • Lobules with hypocellular centers and hypercellular peripheries
  • Giant cells in the hypercellular periphery
  • Scattered calcifications.
  • No true hyaline cartilage formation is seen
  • No mitotic activity is seen

Ossifying Fibroma (Osteofibrous dysplasia)

Gross Pathology

On gross pathology, discrete mass that is well delineated from surrounding bone, tan-white, rubbery cut surface, firm to gritty and no encapsulation are characteristic findings of ossifying fibroma.

Microscopic Pathology

Following features are noted on microscopic histopathological analysis of ossifying fibroma:

  • They comprise of haphazardly distributed lamellated bony spicules on a background of fibrous stroma.
  • Despite being benign, they can be locally aggressive.
  • Immunohistochemical staining of lesions shows positive keratin cells in the majority of the cases.
  • The lesion has a zonal architecture with a center of immature bone surrounded by more mature lamellar bone.
  • The central spicules of woven bony trabeculae are lined by a layer of osteoblasts. The background is a loose and storiform fibrous tissue.

Pathogenesis

  • Ossifying fibroma may be either a clonal neoplastic lesion or a developmental dysplasia.

Associated Conditions

  • It be related to adamantinoma

Non-ossifying Fibroma (nonossifying fibroma, fibrous cortical defect, fibrous metaphyseal defect, fibroxanthoma of bone)

Gross Pathology

On gross pathology, fleshy, fibrous, yellow or tan-brown lesion with variable areas of haemorrhage are characteristic findings of non-ossifying fibroma.

Microscopic Pathology

The following features are seen on microscopic histopathological analysis of non-ossifying fibroma:

  • Spindle cells without cytologic atypia are arranged in a storiform pattern.
  • Scattered chronic inflammatory cells and benign giant cells.
  • Foam cells and hemosiderin deposition are present.
  • Mitoses are seen but cytologic atypia is absent.

Location

  • Metaphysis of distal femur or proximal tibia (80%)
  • Cortical
  • Metaphysis
  • Long bone
  • Eccentric location

Associated Conditions

  • Neurofibromatosis-type 1 (NF1)
  • Fibrous dysplasia
  • Jaffe-Campanacci syndrome

Desmoplastic Fibroma

Microscopic Pathology

The following features are seen on microscopic histopathological analysis of desmoplastic fibroma:

  • Lamellar bone
  • Fibrotic marrow space has following features:
    • Collagen
    • Low cellularity
    • Spindle cells without significant atypia
  • On histopathology, desmoplastic fibromas are identical to soft tissue desmoid tumors, with abundant collagenous stroma and little cellularity or pleomorphism.
  • The main cell types that are seen include the following:
    • Fibroblasts
    • Myofibroblasts
    • Undifferentiated mesenchymal cells

Pleural Fibroma

Microscopic Pathology

The following features are seen on microscopic histopathological analysis of pleural fibroma:

  • Pleural fibromas are composed of irregularly arranged fascicles comprising of spindle cells with collagen separation.
  • They originate from submesothelial mesenchymal cells.
  • Myxoid or cystic degeneration can occur.

Location

  • Approximately 80% of pleural fibromas arise from the visceral pleura, with the remainder arising from the parietal pleura. There may be a predilection towards the mid to lower zones of the chest.

References

Template:WH Template:WS