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Case Reports
. 2021 Jul-Sep;62(3):849-853.
doi: 10.47162/RJME.62.3.25.

Intranodal palisaded myofibroblastoma expressing DOG1: focusing on the potential diagnostic pitfalls

Andreas Kontosis  1 , Evripidis Valanikas, Theodosis Papavramidis, Triantafyllia Koletsa
Affiliations
Case Reports

Intranodal palisaded myofibroblastoma expressing DOG1: focusing on the potential diagnostic pitfalls

Andreas Kontosis et al. Rom J Morphol Embryol. 2021 Jul-Sep.

Abstract

Intranodal palisaded myofibroblastoma (IPM) is a rare, benign mesenchymal neoplasm of the lymph nodes with a broad differential diagnosis. We report a case of an 82-year-old woman presenting with a slow growing, right inguinal mass. The tumor arose as a circumscribed neoplasm inside a lymph node and consisted of bland spindle cells with nuclear palisading and intervening areas of amianthoid-like fibers among interstitial hemorrhage and hemosiderin-laden histiocytes in the stroma, typical histomorphological characteristics of IPM. Immunohistochemically, the neoplastic cells were positive for vimentin, smooth muscle actin (SMA), β-catenin, cyclin D1 and discovered on gastrointestinal stromal tumor (GIST) 1 (DOG1) immunostainings. A literature review and differential diagnosis of IPM are discussed. To the best of our knowledge, this is the first case of DOG1 immunoexpression in a case of IPM.

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Conflict of interest statement

The authors declare no potential conflict of interests with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Computed tomography revealed an enlarged lymph node (arrow) in the right inguinal area
Figure 2
Figure 2
(A) The neoplasm was surrounded by a fibrous capsule, compressing the residual lymphoid tissue of the lymph node. (B) It is composed of spindle cells with nuclear palisading (C) and intervening stellate or round eosinophilic areas, that stained blue (D) with Masson’s trichrome histochemical staining. The same staining reveals (E) intracellular salmon-colored inclusions (arrows). (F) Hemorrhagic areas and hemosiderin-laden histiocytes are found in the stroma. Hematoxylin–Eosin (HE) staining: (A and B) ×100; (C and F) ×400. Masson’s trichrome staining: (D) ×100; (E) ×400
Figure 3
Figure 3
Tumor cells show diffuse positivity to SMA (A), strong nuclear positivity to β-catenin (B) and diffuse positivity to DOG1 (C). The Ki67 proliferation index was low (<2%) (D). Anti-SMA antibody immunomarking: (A) ×100. Anti-β-catenin antibody immunomarking: (B) ×100. Anti-DOG1 antibody immunomarking: (C) ×400. Anti-Ki67 antibody immunomarking: (D) ×100. DOG1: Discovered on gastrointestinal stromal tumor (GIST) 1; SMA: Smooth muscle actin
Figure 4
Figure 4
A whorled oval-shaped structure is observed in an adjacent small nerve trunk. HE staining, ×100
See this image and copyright information in PMC

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