Elastofibroma: Cytomorphologic, histologic, and radiologic findings in five cases

Elastofibroma is a rare benign, solid, ill-defined and slow-growing soft tissue lesion that typically arises between the tip of scapula and chest wall of elderly. Fine needle aspiration (FNA) is a commonly used technique to definitively diagnose the condition. However, the collagenous nature of the mass often results in a paucicellular FNA smear, resulting in a false-negative report. Herein, we report cytomorphologic, histological, and radiologic findings in five cases. Five cases of elastofibroma were retrospectively retrieved from the cytopathology archives of a teaching hospital. The cytological material was obtained by CT-guided (n = 2) and ultrasound-guided (n = 3) FNA. Smears were stained with Diff-Quik and Papanicolaou stains. Elastic stain and mucicarmine were reviewed in one case. Radiologic images and medical records and histology of all cases were reviewed. There were four patients (two men and two women). Their ages ranged from 64 to 84 (mean = 71.25 years). All tumors were subscapular (n = 2 right side, n = 1 left side, and one bilateral). Tumor sizes ranged from 3.3 to 7.5 cm in greatest dimension. Aspirated material was hypocellular in all cases, consisting of scattered uniform spindle cells, mature adipocytes, and collagen. Petaloid globules and serrated and braid-like linear elastic fibers were haphazardly scattered. The characteristic petaloid globules typical of elastofibroma in aspirated material can be inadvertently mistaken or overlooked sincethe samples are hypocellular. Awareness of cytomorphologic features of elastofibroma and the typical clinical setting will permit an accurate diagnosis and eliminate the need for preoperative biopsy. Diagn. Cytopathol. 2012.