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High power view of an abdominal desmoid
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High power view of an abdominal desmoid

A high power view of a desmoid tumor.
The two black arrows point to infiltrating inflammatory cells within the lesion.
The multitude of green arrows point to the large vesicular nuclei that reflect active fibroblasts.
It would be instructive to view this image in association with resting dermal fibroblasts.
In normal dermal collagen, one would see relatively few nuclei, and these would be elongated and homogeneously dark staining, reflecting that inactive state.
In contrast, the nuclei in this field are many, distinctly larger and have a lighter staining character.
All these features are typical of active fibroblasts.
There is some controversy whether a desmoid tumor is a true neoplasm, or an over-reactive reparative response to an injury.
(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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