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Patología Revista Latinoamericana

2012, Number 4

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Patol Rev Latinoam 2012; 50 (4)

Stromal tumors of lower genital tract: angiomiofibroblastoma and fibroepithelial stromal polyp

Torre RFE, Peralta SJY, Ruiz MJL

Language: Spanish
References: 34
Page: 285-292
PDF size: 333.42 Kb.


ABSTRACT

Mesenchymal tumors of lower genital tract were reviewed from two mexican laboratories, institutional and private. In the period 1987-2012 fourteen cases were found under the diagnoses angiomyofibroblastoma and stromal polyp. No cases of aggresive angiomyxoma or superficial myofibroblastoma were identified. Our review was focused on mesenchymal tumors of presuntive myofibroblastic diferrentiation and desmin expression by immunohistochemistry. Five cases of angiomyofibroblastoma in vulva and groin were analyzed for desmin and other markers. Desmin was positive in all of them, muscle actin, S 100 protein and calponin were expressed variably and CD 34 was negative. Ki 67 disclosed low proliferative activity, less than 10%. Nine cases were selected as fibroepithelial polyps, one was reclassified as acrochordon with lichenoid inflammation and atypical multinucleated stromal cells and considered as a simulator of a perineal stromal polyp. Another exceptional case was a 9.5 cm vulvar tumor in a 14 yr. old girl, recurrent and very pleomorphic. It was classified as an atypical fibroepithelial stromal polyp. All cases were desmin positive and reacted variably to antiboides anti-muscle actin, CD 34, S 100 protein and calponin. Estrogen and progesterone receptors were positive in both groups in all cases. We explored 18 surgical specimens from cervix, vagina and vulva with diagnosis different to mesenchymal tumors looking for desmin positive stromal cells, one hyperplastic endocervical polyp showed fusiform stromal cells positive to this marker. A review on the observations of other authors on the nature and frequency of stromal cells and presumptive desmin positive myofibroblasts was done. The normal equivalent of the neoplastic cells in this neoplasms is still elusive and the significance of reactive atypical stromal cells in anogenital lesions is also unclear.


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