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Low power view of an abdominal desmoid
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Low power view of an abdominal desmoid

A medium power view of a desmoid tumor reveals that a typical field contains at least two types of nuclei.
The black arrows point to small, round nuclei that represent infiltrating inflammatory cells.
The green arrows point to vesicular, but elongated nuclei, typical of active fibroblasts.
It would be useful to contrast this image with that of normal resting dermal fibroblasts.
Normal resting fibroblasts will reveal elongated, small, darkly staining nuclei that lie along the course of the collagen bundles.
In addition, a high power field such as this, there would be far fewer fibroblast nuclei.
The increased cellularity, as well as the larger size and the vesicular appearance of the nuclei is reflective of the state of activity of this lesion.
There is some controversy whether desmoid tumor is a true neoplasm, or an over-reactive reparative response.
(Description By:T.V.Rajan, M.D. )
(Image Contrib. by:T.V.Rajan, M.D. UCHC )
Desmoid
Etiology

Unknown.
Pathogenesis

The lesion represents an intermediate between a reparative lesion and a true malignancy.,
Epidemiology

The intra-abdominal variety is associated with pregnancy.
The extra-abdominal variety is seen equally in men and women.
The tumor is common in patients with Gardner's syndrome, a disease associated with a diverse array of neoplastic lesions, including colonic polyps, osteomas and epidermal inclusion cysts.
General Gross Description

Also known as aggressive fibromatosis.
Lesions characterized by tan-white, poorly demarcated masses.
They are rubbery, firm and blend into the surrounding tissue.
General Microscopic Description

Histologically characterized by active fibroblasts within a dense collagenous matrix.
Mitotic activity is not frequent.
Fragments of skeletal muscle cells can be seen embedded within the tumor.
Clinical Correlation

Desmoids are treated by surgical excision.
Although locally invasive, they rarely metastasize.
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 90, 1265.
Desmoid
Synopsis by: T.V. Rajan M.D. Ph.D. (T1X000M88211)[84]
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