title: Vulvovaginal myofibroblastoma: expanding the morphological and immunohistochemical spectrum. A clinicopathologic study of 10 cases.
abstract: We analyzed the clinicopathologic features of 10 cases of vulvovaginal myofibroblastoma to widen its morphological and immunohistochemical spectrum. Most tumors (8/10 cases) were located in the vagina. The patients' age ranged from 44 to 77 years, and tumor size ranged from 0.4 to 3 cm. Histologically, 5 tumors had the characteristics of vulvovaginal myofibroblastoma. In addition, we identified 3 cases composed of spindle-shaped cells arranged in short fascicles with intervening thick collagen bands, closely reminiscent of mammary myofibroblastoma. Notably, 1 case resembled Sertoli cell tumor, sclerosing type, because of its predominant cord-like arrangement. In another case, there were highly cellular areas composed of uniform-packed, rounded cells that, at low magnification, looked like a malignant "small round blue cell tumor." A variably thick band of native connective tissue separated tumors from the overlying squamous epithelium even if, in 3 cases, tumor cells extended up to the epithelium. In 7 cases, a variable number of vessels showed perivascular hyalinization. Only rare mitotic figures were identified. All tumors were diffusely positive for vimentin, desmin, and CD99. A variable staining intensity was observed for CD34, Bcl-2, B-cell lymphoma 2 (Bcl-2) CD10, estrogen receptor, and progesterone receptor in most cases, but none expressed α-smooth muscle actin. We emphasize that vulvovaginal myofibroblastoma encompasses a morphological spectrum wider than previously described. The overlapping morphological and immunohistochemical features of vulvovaginal and mammary myofibroblastomas led us to speculate that these are related entities with morphological variations on a common basic theme likely dependent on anatomical location.
authors.affiliation: GF Ingrassia Department, Section of Anatomic Pathology, Policlinico Universitario-Vittorio Emanuele, University of Catania, 95123 Catania, Italy. g.magro@unict.it
authors.forename: Gaetano
authors.initials: G
authors.lastname: Magro
authors.forename: Rosario
authors.initials: R
authors.lastname: Caltabiano
authors.forename: Denisa
authors.initials: D
authors.lastname: Kacerovská
authors.forename: Giada Maria
authors.initials: GM
authors.lastname: Vecchio
authors.forename: Dmitry
authors.initials: D
authors.lastname: Kazakov
authors.forename: Michal
authors.initials: M
authors.lastname: Michal
mesh_terms: D000071443:12E7 Antigen; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D015815:Cell Adhesion Molecules / Q000378:metabolism; D003893:Desmin / Q000378:metabolism; D005260:Female; D006801:Humans; D008875:Middle Aged; D009379:Neoplasms, Muscle Tissue / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D014625:Vaginal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D014746:Vimentin / Q000378:metabolism; D014846:Vulvar Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
chemical_list: D000071443:12E7 Antigen; D015703:Antigens, CD; D014408:Biomarkers, Tumor; C061828:CD99 protein, human; D015815:Cell Adhesion Molecules; D003893:Desmin; D014746:Vimentin