Ischemic fasciitis: a juxta-skeletal fibroblastic proliferation with a predilection for elderly patients.
We are reporting six examples of a distinctive reactive fibroblastic proliferation occurring predominantly in elderly bed-ridden or convalescent patients that presents as an ill-defined mass often overlying a bony prominence or in close apposition to the periosteum of bone. Unlike conventional fasciitis, the lesion achieves a relatively larger size and is characterized by a biphasic appearance with an outer fringe of mitotically active fibroblasts and capillaries circumscribing a central area of liquefactive and focally coagulative necrosis. Follow-up information in all patients indicated no evidence of aggressive behavior. We believe these lesions arise on an ischemic basis, similar to a decubitus ulcer, from long-standing or intermittent pressure on the soft tissue structures. Because of their large size and close proximity to bone, they are commonly mistaken for a sarcoma.
Perosio
P M
PM
Department of Pathology, University of Michigan Hospital, Ann Arbor.
Weiss
S W
SW
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002455:Cell Division; D005208:Fasciitis / Q000209:etiology / Q000473:pathology*; D005260:Female; D005347:Fibroblasts / Q000473:pathology*; D006801:Humans; D007511:Ischemia / Q000150:complications*; D008297:Male