Korean J Dermatol.
2009 Jun;47(6):649-657.
Clinical and Histopathologic Review on 28 Cases of Nodular Fasciitis
- Affiliations
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- 1Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.
- 2Department of Dermatology, Seoul National University College of Medicine, Boramae Hospital, Seoul, Korea. sycho@snu.ac.kr
- 3Department of Dermatology, Chung-Ang University College of Medicine, Yongsan Hospital, Seoul, Korea.
- 4Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Abstract
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BACKGROUND: Nodular fasciitis presents as a solitary, slightly painful, rapidly growing nodule. It is associated with a reactive, proliferative process of unknown cellular origin and can be misdiagnosed as a sarcoma.
OBJECTIVE
Our study was designed to investigate the process and cellular origin of the disease.
METHODS
The clinical and histopathologic findings from 28 cases of nodular fasciitis were reviewed. Additional histochemical and immunohistochemical staining was done.
RESULTS
The mean age of onset was 29.8 years. A majority of patients with nodular fasciitis had a duration of symptoms of less than 6 months. The upper extremity and face were most frequently involved. Most of the lesions had diameters less than 2 cm. Total excisions were performed in 23 lesions; 3 lesions recurred thereafter. Histopathologically, a subcutaneous plane was most frequently involved. The nodule consisted of numerous large, pleomorphic fibroblasts growing haphazardly in a vascular stroma containing varying amounts of mucoid ground substance, which was confirmed by histochemical stains. In the immunohistochemical stain, most lesions had positive findings for smooth muscle actin (SMA), vimentin and negative findings for CD34 except in a few cases. The stains for desmin and S-100 were negative in all cases.
CONCLUSION
It is suggested that nodular fasciitis is associated with a reactive proliferation of myofibroblasts rather than with a sarcomatous process.
