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Table 5 Differential diagnoses of SFT (in accordance with Fletcher et al. and Doyle et al.[1],[11])

From: Solitary fibrous tumor – clinicopathologic, immunohistochemical and molecular analysis of 28 cases

  Histopathological characteristics IHC Genetic alterations
Dedifferentiated liposarcoma lipogenic component with atypia MDM2 +, CDK4 + amplification MDM2
  atypia in dediff. component can be mild STAT6 −/+  
Deep benign fibrous histiocytoma storiform or short fascicles, branching vasculature CD34 +/−, SMA f+/−, STAT6 −/+  
Spindle cell lipoma short stubby nuclei, ropey collagen CD34+ RB1 deletion
  variable proportions of fat   
Cellular angiofibroma short stubby nuclei, wispy collagen CD34 +/−, desmin −/+ RB1 deletion
  numerous (hyalinized) vessels SMA −/+,  
Mammary type myofibroblastoma (long) fascicles, short stubby nuclei CD34 +, desmin + RB1 deletion
  broad bands collagen SMA −/+,  
Myofibroma biphasic, immature spindle cells and mature myoid cells, bluish matrix, branching vessels SMA +/−, desmin −/+, CD34 −/+  
Dermatofibrosarcoma protuberans storiform, short fascicles, uniform spindle cells, “honeycomb” appearance of fat CD34 + COL1A1-PDGFB
Monophasic synovial sarcoma cellular fascicles, uniform spindle cells TLE1 +, EMA +, CK + SYT-SSX1/2
Cellular schwannoma short bundles, interlacing fascicles S100 + NF2 mutations
  tapered nuclei, hyalinized (ectatic) vessels   
Perineurioma storiform, whorled growth, bipolar cells, uniform oval or tapering nuclei CD34 +/−, EMA +, Claudin-1−/+, GLUT1 −/+  
Low-grade fibromyxoid sarcoma alternating hypo- and more cellular fascicles and whorls, fibrous and myxoid background, bland spindle cells MUC4 +, EMA + FUS-CREB3L1/2
Inflammatory myofibroblastic tumor fascicles of myofibroblasts, myxoid or SMA +/−, desmin +/− ALK rearrangement +/−
  collagenous background, inflammation ALK +/−  
Sarcomatoid mesothelioma fascicles or haphazard distribution, atypical spindle cells CK, EMA, D2-40, caretinin, WT1 BAP1 mutation [23]
Inflammatory fibroid polyp onion-skin pattern, short fascicles CD34 +/− PDGFRA mutation
of the GI tract [24] cells, prominent vasculature, inflammatory especially eosinophils   
Soft tissue angiofibroma [25] variably collagenous and myxoid areas EMA +/−, CD34 −/+ GTF2I-NCOA2[26]
  numerous small branching capillaries   AHRR-NCOA2[27]