PMID- 29623468
OWN - NLM
STAT- MEDLINE
DCOM- 20180904
LR  - 20200113
IS  - 1432-2307 (Electronic)
IS  - 0945-6317 (Linking)
VI  - 473
IP  - 3
DP  - 2018 Sep
TI  - Misses and near misses in diagnosing nodular fasciitis and morphologically 
      related reactive myofibroblastic proliferations: experience of a referral center 
      with emphasis on frequency of USP6 gene rearrangements.
PG  - 351-360
LID - 10.1007/s00428-018-2350-0 [doi]
AB  - Although harmless, reactive and benign neoplastic myo-/fibroblastic 
      proliferations represent a diagnostic challenge in routine surgical pathology 
      practice as reflected by their frequency among consultation cases. In addition to 
      resembling each other, the prototypical nodular fasciitis (NF) and NF-like 
      lesions can be mistaken for low-grade or aggressive sarcomas. USP6 translocation 
      was reported recently as the molecular driver and potential diagnostic marker of 
      NF. We reviewed 71 lesions with a diagnosis of NF (n = 48) or NF-like 
      myofibroblastic proliferations (n = 23) and screened them for USP6 translocation 
      by fluorescence in situ hybridization (FISH). Only one third of NFs were 
      correctly diagnosed by submitting pathologists while one third was initially 
      judged as malignant. NF was mentioned in the differential diagnosis in only half 
      of the cases. A high Ki67/mitotic index, misleading immunohistochemistry 
      (false-positive h-caldesmon), and unusual sites/circumscription were main causes 
      behind overdiagnosis as malignant. FISH analysis revealed USP6 translocation in 
      74.4% of NF cases. None of the reactive/reparative myofibroblastic proliferations 
      showed USP6 translocation. NF is still significantly misdiagnosed by general 
      surgical pathologists, with a higher tendency toward overdiagnosis of malignancy. 
      Inclusion of NF in the differential diagnosis of any fibromyxoid soft tissue 
      lesion and awareness of its diverse morphology are mandatory to avoid 
      misdiagnoses with the risk of disastrous overtreatment. In the appropriate 
      clinicopathological context, USP6 gene translocation is a valuable adjunct for 
      diagnosis of NF, particularly in limited biopsies. Absence of the USP6 gene 
      translocation in NF-like reparative pseudosarcomatous myofibroblastic 
      proliferations underlines their reactive nature and distinguishes them from NF 
      which is currently considered a benign neoplasm with a self-limiting "transient" 
      growth phase.
FAU - Erber, Ramona
AU  - Erber R
AD  - Institute of Pathology, Friedrich-Alexander University Erlangen-Nurnberg (FAU), 
      Krankenhausstrasse 8-10, 91054, Erlangen, Germany.
FAU - Agaimy, Abbas
AU  - Agaimy A
AD  - Institute of Pathology, Friedrich-Alexander University Erlangen-Nurnberg (FAU), 
      Krankenhausstrasse 8-10, 91054, Erlangen, Germany. abbas.agaimy@uk-erlangen.de.
LA  - eng
PT  - Journal Article
DEP - 20180405
PL  - Germany
TA  - Virchows Arch
JT  - Virchows Archiv : an international journal of pathology
JID - 9423843
RN  - 0 (Proto-Oncogene Proteins)
RN  - EC 3.4.19.12 (USP6 protein, human)
RN  - EC 3.4.19.12 (Ubiquitin Thiolesterase)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Diagnostic Errors
MH  - Fasciitis/diagnosis/*genetics/pathology
MH  - Female
MH  - *Gene Rearrangement
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Male
MH  - Middle Aged
MH  - Myofibroblasts/*pathology
MH  - Proto-Oncogene Proteins/*genetics
MH  - Ubiquitin Thiolesterase/*genetics
OTO - NOTNLM
OT  - Fibroma of tendon sheath
OT  - Heterotopic ossification
OT  - Myofibroblastic sarcoma
OT  - Myositis ossificans
OT  - Myxofibrosarcoma
OT  - Nodular fasciitis
OT  - Proliferative fasciitis
OT  - Sarcoma
OT  - USP6 translocation
EDAT- 2018/04/07 06:00
MHDA- 2018/09/05 06:00
CRDT- 2018/04/07 06:00
PHST- 2018/03/05 00:00 [received]
PHST- 2018/03/27 00:00 [accepted]
PHST- 2018/03/26 00:00 [revised]
PHST- 2018/04/07 06:00 [pubmed]
PHST- 2018/09/05 06:00 [medline]
PHST- 2018/04/07 06:00 [entrez]
AID - 10.1007/s00428-018-2350-0 [pii]
AID - 10.1007/s00428-018-2350-0 [doi]
PST - ppublish
SO  - Virchows Arch. 2018 Sep;473(3):351-360. doi: 10.1007/s00428-018-2350-0. Epub 2018 
      Apr 5.