Nodular Fasciitis in the Head and Neck: A Clinicopathological Study of 18 Cases

Dahl, Ingvar; Jarlstedt, Jan

doi:10.3109/00016488009131711

Cited by 51 publications

(31 citation statements)

References 16 publications

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“…In the light of the different managements of these 2 lesions, careful distinction by adequate FNAB is essential [12,13,14,15,16,17]. Accurate diagnosis by FNAB can provide reassurance to the clinical team when deciding to observe the lesion for regression, rather than to excise it for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Nodular Fasciitis: Definitive Diagnosis by Fine Needle Aspiration

Berry¹,

Jaffee²,

Greenberg³

et al. 2016

Acta Cytologica

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Objectives: Nodular fasciitis (NF) is a self-limited, mass-forming, fibrous proliferation that can occur in the head and neck and may mimic malignancy. Fine-needle aspiration biopsy (FNAB) is a minimally invasive, rapid, accurate method of obtaining diagnostic material from head and neck masses. In this study, we verify the usefulness of FNAB in obtaining a definitive diagnosis of NF. Methods: Cases were identified from our laboratory information system. Cytology slides were reviewed to note morphologic features and confirm diagnoses. Clinical history was obtained to document the case presentations and outcomes. Results: All 9 cases were found to have clinical presentations and common distinguishing morphologic features consistent with NF. Two cases were excised surgically, and the remainder regressed spontaneously. There were no recurrences. Conclusions: FNAB can produce a definitive diagnosis of NF, providing an opportunity to avoid surgical excision in patients with a typical clinical presentation.

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Section: Discussionmentioning

confidence: 99%

Nodular Fasciitis: Definitive Diagnosis by Fine Needle Aspiration

Berry¹,

Jaffee²,

Greenberg³

et al. 2016

Acta Cytologica

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“…Clinical series of ''head and neck soft tissue tumors'' were selected if critical information about parotid gland NF were included (Table 3) [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Foreign language articles were only included if they were published alongside an English translation and articles with limited or lacking parotid gland information or duplicate publications were excluded [18][19][20][21][22][23][24].…”

Section: Methodsmentioning

confidence: 99%

Parotid Gland Nodular Fasciitis: A Clinicopathologic Series of 12 Cases with a Review of 18 Cases from the Literature

Gibson

Bishop

Thompson

2014

Head and Neck Pathol

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Nodular fasciitis (NF), very uncommon in the parotid gland, is a benign myofibroblastic proliferation that may be mistaken for other neoplastic proliferations. The mass-like clinical presentation and histologic features result in frequent misclassification, resulting in inappropriate clinical management. There are only a few reported cases in the English literature. Cases within the files of the authors' institutions (retrospective) confined to the parotid gland were compared to cases reported in the English literature (Medline 1966-2014). The patients included five females and seven males, aged 11-70 years (mean 45.2 years). All patients presented with a mass lesion, present on average 1.9 months, without a documented history of trauma. The lesions were 0.7-5.2 cm (mean 2.2 cm). Seven patients had fine needle aspiration. The majority of the lesions were circumscribed (n = 9), composed of spindle-shaped to stellate myofibroblasts (MF) arranged in a storiform growth pattern, juxtaposed to hypocellular myxoid tissue-culture-like areas with extravasation of erythrocytes. Dense, keloid-like collagen (n = 7) and occasional giant cells were seen (n = 6). Mitotic figures (without atypical forms) were readily identifiable (mean 4/10 HPFs). By immunohistochemical staining, the MF were reactive with vimentin, actins, and calponin, while the histiocytes were reactive with CD68. All patients had surgical excision. One patient developed local recurrence (12 months later). All were alive and disease free at last follow-up, with a mean 133 months of follow-up. The principle differential diagnoses include fibrosarcoma, fibromatosis, pleomorphic adenoma, myoepithelioma, neurofibroma, schwannoma, solitary fibrous tumor, leiomyoma, fibrous histiocytoma and myxoma. NF of the parotid gland occurs in middle-aged patients who present with a mass (mean 2.2 cm) in the parotid gland of short duration (1.9 months). FNA misinterpretation frequently leads to excision. Separation from myoepithelial and mesenchymal lesions affecting the parotid gland results in appropriate management.

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“…This pseudosarcomatous soft tissue tumor occurs mostly in the subcutaneous fat and fascia of the upper extremities in adults [10]. Fifteen percent of cases occur in the subcutaneous tissues of the head and neck, half of which are found in children, showing a predilection for this anatomical site in the younger population [11][12][13]. Most commonly, the cranium is involved [14], but other sites such as the external auditory canal [15], dermis and the eyelids have been described [12,16].…”

Section: Discussionmentioning

confidence: 96%