Elastofibroma dorsi is a rare benign lesion of the soft tissue of the thoracic wall, usually located in the subscapular region. It occurs mostly in elderly women patients. This lesion usually arises in right region but it can also be bilateral. Even if the pathogenesis is still unknown, it is considered that "rubbing" of the scapula against the thorax wall could determine growth of the elastofibroma. The differential diagnosis from sarcoma is required but the typical localization and the MRI suggest the diagnosis which should be confirm with the histological exam. The Authors present their experience on five patients, with a median age of 64, affected by elastofibroma dorsi. In two cases, a builder and an obstetrician, the lesion was bilateral; in the other three cases, two teachers and a notary, the lesion are right-sided. A thorax computed tomography (CT) revealed a lesion with heterogeneous density, and the magnetic resonance imaging (MRI) , shows intralesional areas of medium and high intensity signals in the tissue with low intensity in both T12 and T2-sequences. The patient underwent surgery and diagnosis was confirmed by the histological exam. Prevalence of the right localization reported in literature, the correlation between the job of the patients and the lesion localization, more evident in the women, confirmed, according to the other Authors, the etiological hypothesis which considers the lesion as a proliferative response of the connective tissue to the repeated mechanical stress which excessive elastic fibrollogenesis probably due to genetic predisposition.
[Show abstract][Hide abstract] ABSTRACT: Elastic fibers are important components of the skin and are responsible for skin elasticity. Genetic defects are well-known in numerous hereditary elastic tissue disorders and skin biopsies are often the first step in the evaluation of those disorders. Verhoeff-Van Gieson elastic staining is a simple method that is used for visualizing elastic fibers. With the development of modern immunohistochemical methods, the value of routine histochemical staining is sometimes underestimated. Histochemical stains are less expensive, easy to perform and help to resolve numerous diagnostic quandaries in dermatopathology. This article focuses on the value of elastic tissue staining in dermatopathology, with a focus on primary elastic tissue disorders, alopecia, inflammatory skin disorders and neoplastic proliferations.
[Show abstract][Hide abstract] ABSTRACT: Elastofibroma dorsi (ED) is considered a member of a heterogeneous group of benign fibrous (fibroblastic or myofibroblastic) soft tissue tumors, frequently localized in the periscapular region in middle aged or older
individuals. However, the pathogenesis of ED is still unclear and many authors believe that ED results from a reactive hyperproliferation of fibroblastic tissue, while others suggest that it may be a consequence of a mechanical friction.
In our study, we examined 11 cases of ED using histochemical and immunohistochemical methods, in order to extend the knowledge about extracellular matrix composition and histopathogenesis of ED. From the results it appeared that stroma and interspersed spindle cells of ED were positive for both periostin and
tenascin-C. Mast cells tryptase-positive were also abundant throughout the lesion. The perivascular distribution of periostin and tenascin-C, associated with the CD34 positivity, suggest that endothelial-mesenchymal transition events can account for neovascularization and production of fibroelastic tissue characteristic of elastofibroma. Our data obtained in endothelial cells cultures demonstrated that
elastin production is higher when the status of confluence of the cells is low. So, we can assume that such a phenomenon is a characteristic of mesenchymal/endothelial cells CD34 positive, in which elastin production results to be inversely proportional to the vascular differentiation of cellular elements. In the light of these considerations, we think that a cancerous nature of ED is unlikely. Overall, our study report, for the first time, a detailed description of extracellular matrix composition in ED, suggesting that a mechanical strain-dependent reactivation of periostin and tenascin-C expression, as well as of elastin deposition, could be responsible for development of ED.
European journal of histochemistry: EJH 02/2015; 59(1):10. DOI:10.4081/ejh.2015.2459 · 2.04 Impact Factor
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