Intranodal Palisaded Myofibroblastoma with So-called Amianthoid Fibers: a Report of Two Cases with a Review of the Literature

Two cases of intranodal myofibroblastoma, a rare primary spindle cell tumor of the lymph node, are described. The tumors arose in the inguinal or proximal region of the thigh of one middle-aged and one elderly Japanese male. The tumors were well-demarcated and composed of a fascicular proliferation of spindle cells with focal nuclear palisading and acellular stellate-shaped collagen-rich areas (so-called amianthoid fibers), and were associated with hemorrhagic areas. Immunohistochemically, the tumor cells were positive for vimentin and muscle actin. Together with ultrastructural findings of intracytoplasmic microfilaments with focal densities and profiles of well-developed, rough endoplasmic reticulum, these features reinforced the conclusion of myofibroblastic or smooth muscle differentiation of the tumor cells. One of the tumors was analyzed by flow cytometry and was shown to be DNA diploid. The present report provides clinicopathological findings of the first two Japanese cases of intranodal myofibroblastoma.