Question:

Which of the following is true regarding the histopathologic subtypes of nodular fasciitis?
1. A feathery appearance of the intervening ground substance typically suggests an alternate diagnosis.
2. Atypia and hyperchromatic nuclei are often observed in nodular fasciitis.
3. Nodular fasciitis is categorized into myxoid, cellular, and fibrous subtypes.
4. Different histologic subtypes rarely coexist within the same lesion.
5. Anatomic locations of nodular fasciitis include intradermal, subcutaneous, and intramuscular.





Answer:

The correct answer for the question "Which of the following is true regarding the histopathologic subtypes of nodular fasciitis?" is:

3. Nodular fasciitis is categorized into myxoid, cellular, and fibrous subtypes.



Explanation
1.    An important diagnostic criterion is a pattern of intervening ground substance which gives the lesion a "feathery" appearance.

2.    Features used to distinguish nodular fasciitis from more aggressive lesions such as sarcoma include lack of atypia and hyperchromatic nuclei.

3.    Nodular fasciitis is categorized into three histologic subtypes: myxoid, cellular, and fibrous.

4.    Different histologic subtypes do often coexist in the same lesion, leading some to suggest that there is an age-related histologic transition from myxoid to cellular and then fibrous as the lesion matures.

5.    Nodular fasciitis can be further subdivided based on the basis of its anatomic location: subcutaneous, intramuscular, or intermuscular.



From the manuscript:
Nodular Fasciitis in the Axillary Tail of the Breast
Radiology Case. 2014 May; 8(5):16-26


This article belongs to the Mamms section.




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From the manuscript

Nodular Fasciitis in the Axillary Tail of the Breast

Free full text article: Nodular Fasciitis in the Axillary Tail of the Breast

Abstract
Nodular fasciitis is a benign proliferation of myofibroblasts which presents clinically as a rapidly growing mass with nonspecific features on imaging and high cellular activity on histopathology. Nodular fasciitis can be mistaken for malignant fibrous lesions such as soft tissue sarcoma or breast carcinoma when located within breast tissue. This presents a problem for appropriate treatment planning as the natural history of nodular fasciitis is spontaneous regression. We present the mammographic, sonographic, computed tomography, and histopathologic characteristics of nodular fasciitis in a 68 year female initially presenting with a rapidly enlarging right axillary mass.






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