Case Number : CT0090 Adam_Bates

I was wondering about ancient schwannoma or neurofibroma to explain the rather bizarre atypia, abundant mast cells, and rather sclerotic collagen. Meningothelial hamartoma also crossed my mind.
 

I FAVOUR DIFFUSE NEUROFIBROMA WITH ANCIENT CHANGE. DDx INCLUDES: NUCHAL-TYPE FIBROMA; FIBROMATOSIS; MENINGEAL HAMARTOMA. WOULD LIKE IMMUNOHISTOCHEMICAL STAINS: S100 / CD34 / EMA / VIMENTIN /BETA CATENIN.
 

spindle cell lipoma
 

difficult case, spindle cell tumor, probably neural. I see lots of mast cells, and in the last picture there is nuclear atypia. I favor to be Neurofibroma.
 

pleomorphic/spindle cell lipoma (adipocyte poor)...also thought of gc angiofibroma/sft
 

Forgot to include spindle cell lipoma in my differential diagnosis. The lesion has classical ropey collagen with abundant mast cells. The age and site are also correct.
 

Favour neurofibroma with atypical features (dysplstic)cause of large number of mast cells. DD ancient schwannoma or meningothelial hamartoma.
 

Dysplastic neurofibroma
 

Very late, although I have been seeing many difficult and challenging cases these pase 2 days, but I haven't seen soething like that yet!!!!! Liked all the comments but I think it fits more with spindle cell lipoma, have a sesiion on soft tissue tumors tomorrow, looking forward to it..
 

The main features are the spindled cell population and the ropey collagen. The hyperchromatic giant cells are also a diagnostic clue. Given the clinical history, pleomorphic lipoma is the best diagnosis. Often with aging, the adipocytic component diminishes although it was present elsewhere in this specimen. Well done Marie.
 

Good afternoon... Mast cells, nuclear inclusions.. I think it is a Spindle cell lipoma