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] |