CLINICAL SOCIETY MEETING-

HILLOCK ON THE BACK

Presenter : Dr Reena V K
Moderator: Dr Umashankar
GROSS IMAGE

CIRCUMSCRIBED MASS MEASURING

11x6.5x3.5cm , OUTER SURFACE -
SMOOTH .
CUT SURFACE
Homogeneous, glistening
surface (myxoid)
Scanner view

● Hypocellular lesion
● Myxoid
background
• Hypocellular lesion
• Myxoid background
• Trapping or invading the
adjacent adipose thissue
• 2 components :
1.Tumor cells –
Spindled cells scattered
in a myxoid back
ground.
2. Blood vessels
• Blood channels
• Stroma entrapping the
surrounding fat .
• Tumor cells : Spindled
cells with delicate
cytoplasmic processes.
• Hyalinized blood
vessel.
• Myxoid stroma with
delicate collagen fibres.
Impression

● Features are of angiomyxoma.

Angiomyxoma

● Morphologically distinct , slow growing myxoid neoplasm .

● More commonly seen in genital , perineal and pelvic regions of
adult women.
● F:M = 6:1
ANGIOMYXOMA

● CUTANEOUS ● AGGRESSIVE
• Soft
• Partly circumscribed or
polypoidal.
• Cut surface : glistening ,
homogenous , gelatinous
CUTANEOUS AGGRESSIVE
Grossly: Grossly:
● Thin fibrous septa- multinodular . Lobulated appearance .
● Cysts with keratin debris. Few centimeters to 20cm .
M/E: M/E:
● Lobular appearance , ● Widely scattered spindled to stellate shaped
● Poorly circumscribed- extending in to the cells with ill defined cytoplasm.
subcutaneous tissue. ● Variable number of thin or thick walled blood
channels in a myxoid stroma , rich in collagen
● Mixed stromal inflammatory cells are common. fibres .
● Mitotic figures are rare.
● Basaloid buds ,epithelial strands or epidermal ● Blood vessels may show secondary changes –
cysts (keratin filled) . Hyalinization and medial hypertrophy .
Differential diagnosis

Angiomyofibroblastoma :
Site : vulva , vagina and rarely scrotum .

Gross :
Well circumscribed . Less than 3 cm.

M/E : Plump epitheloid cells – Perivascular distribution .

Binucleated and multinucleated cells are common.
Thin walled vessels – hyalinization .
Recurrance is rare .
● Intramuscular myxoma .
● Juxta-articular myxoma.
● Myxoid neurofibroma.
● Fibroepithelial stromal polyp .
● Myxofibrosarcoma .