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Morphometric analyses of elastic tissue fibers in dermatofibroma: clues to etiopathogenesis?


Meera Mahalingam, MD, PhD, FRCPath, 609 Albany Street, J-301, Boston, MA 02118, USA
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Background: The etiopathogenesis of dermatofibroma (DF), a common benign fibrohistiocytic tumor, is debatable. The goal of this study was to ascertain the density of elastic tissue fibers in DF in an effort to investigate whether this provides an insight into its etiopathogenesis.

Method: Three groups comprising eight cellular DFs, eight paucicellular DFs and eight scars (control group) were stained with a modified Verhoeffs-van Gieson (without counterstain), and elastic fibers in three randomly selected fields within the lesional area/case semiquantitatively analyzed and examined in a blinded fashion.

Result: The mean density of elastic tissue fibers in cellular DF was 6.81 (1.38–15.89); in paucicellular DF, 2.46 (0.14–5.79) and in scar, 2.95 (0.97–10.69). Overall, significant differences in density of elastic tissue fibers were observed only between cellular DF and the other two groups (vs. paucicellular variant, p = 0.03 and vs. scar, p = 0.05). Morphological changes observed included thickness, clumping, elongation and waviness (cellular DF) and margination of elastic tissue fibers (paucicellular variant).

Conclusion: While the jury still appears to be out regarding the etiopathogenesis of DF, the reduction in density of elastic tissue fibers in the paucicellular variant compared with its cellular counterpart lends credence to the concept of evolutionary stages of DF.