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Presented by Jonathan Epstein, M.D. and prepared by Mohammed Lilo, M.D.
Case 3: An ill-defined lesion was removed from the posterior shoulder of a 65 year old female.
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1. Question
Week 604: Case 3
An ill-defined lesion was removed from the posterior shoulder of a 65 year old female.images/lilo/JIE/JE-3-A.jpg
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images/lilo/JIE/JE-3-E.jpgCorrect
Answer: Elastofibroma
Histology: There is a non-circumscribed mass of fibrous tissue within the soft tissue. It consist of an admixture of heavy dense bands of collagenous tissue dissected by fat and abnormal elastic fibers. The elastic fibers are coarse, thick, and darkly eosinophilic, often fragmented into globules.
Discussion: This lesion is a classic example of elastofibroma both in histology and location. Although the characteristic elastic fibers can be seen on H&E sections, elastic stains (i.e. VVG) can highlight the abnormal elastic fibers where they have the appearance of “string of pearls” or “beads on a string”. These tumors are often related to hard manual labor, more common in women, and usually seen in individuals over 55 years of age. Simple resection is curative.
Incorrect
Answer: Elastofibroma
Histology: There is a non-circumscribed mass of fibrous tissue within the soft tissue. It consist of an admixture of heavy dense bands of collagenous tissue dissected by fat and abnormal elastic fibers. The elastic fibers are coarse, thick, and darkly eosinophilic, often fragmented into globules.
Discussion: This lesion is a classic example of elastofibroma both in histology and location. Although the characteristic elastic fibers can be seen on H&E sections, elastic stains (i.e. VVG) can highlight the abnormal elastic fibers where they have the appearance of “string of pearls” or “beads on a string”. These tumors are often related to hard manual labor, more common in women, and usually seen in individuals over 55 years of age. Simple resection is curative.
