Aspiration cytology of elastofibroma dorsi: Case report with ultrastructural and immunohistochemical findings

Abstract

Elastofibroma is a well-recognized tumor-like process which typically occurs in the soft tissue of the shoulder. Although fine-needle aspiration (FNA) represents a quick and simple method for definitive diagnosis, the possibility of a false-negative diagnosis is high due to the hypocellularity of the smears. However, a high index of suspicion based on the clinical presentation of a firm mass in a typical location in an elderly person, usually female, aids in the diagnosis. We describe the FNA findings of elastofibroma dorsi in an 89-yr-old woman which, although hypocellular, contained diagnostic aggregates of petaloid globules within a collagenous matrix. The cytologic material showed a green-yellow autofluorescence of the altered elastic fibers with ultraviolet light. Transmission electron microscopy revealed an elongated beaded appearance with small electron densities and obliteration of the central elastin core. The presence of a hypocellular aspirate with autofluorescent elastic fibers should suggest the possibility of elastofibroma dorsi.

Acquired disorders of elastic tissue: part I. increased elastic tissue and solar elastotic syndromes

“…The absence of lysozyme, which is known to associate with elastic fibers that have sustained traumatic insult, argues against the hypothesis that elastofibroma is a degenerative process that results from chronic trauma, although this finding is not universal. 40,41 Alternatively, elastofibroma may be a benign neoplastic process or the result of neoelastogenesis, the accumulation of newly synthesized elastic fibers. 39,40 Clinical manifestations.…”

“…40,41 Alternatively, elastofibroma may be a benign neoplastic process or the result of neoelastogenesis, the accumulation of newly synthesized elastic fibers. 39,40 Clinical manifestations. Elastofibroma is characterized by an asymptomatic or mildly tender, slowly growing, solid, unencapsulated, ill-defined nodule most often deep to the greater rhomboid and latissimus dorsi muscles and adjacent to the apex of the scapula.…”

Salivary Gland and Soft Tissue Ultrasound-Guided Fine-Needle Aspiration

“…2E). 20,21 EVG stain highlights the compactly and randomly arranged elastic microfibrils with serrated borders (petaloid globules) (Fig. 2F).…”

Exercise-Induced Elastofibroma Dorsi

“…On the other hand, in recent years, it was claimed that the definitive preoperative diagnosis could be achieved by fine-needle aspiration; thus, a more invasive means of obtaining a tissue diagnosis could be obviated (9). But, although Harigopal et al (10) said that the possibility of a false-negative diagnosis was high due to the hypocellularity of the smears, they also claimed that the presence of autofluorescent elastic Macroscopically, the lesion is usually oval and unencapsulated with the margins ill defined. Its cut surface is tan-white and heterogeneous in appearance.…”