Nuclear β-catenin expression distinguishes deep fibromatosis from other benign and malignant fibroblastic and myofibroblastic lesions

Baishali Bhattacharya, Harrison Parry Dilworth, Christine Iacobuzio-Donahue, Francesca Ricci, Kristin Weber, Mary A. Furlong, Cyril Fisher, Elizabeth Montgomery

Research output: Contribution to journalArticlepeer-review

Abstract

Deep fibromatoses (desmoid tumors) are clonal myofibroblastic proliferations that are prone to aggressive local recurrences but that do not metastasize. They must be distinguished from a host of fibroblastic and myofibroblastic lesions as well as from smooth muscle neoplasms. Virtually all deep fibromatoses have somatic β-catenin or adenomatous polyposis coli (APC) gene mutations leading to intranuclear accumulation of β-catenin. Since low-grade sarcomas in general lack β-catenin and since reactive proliferations would not be expected to have it, we predicted that nuclear β-catenin expression would be detected in deep fibromatoses but absent in other entities in the differential diagnosis. We evaluated the role of β-catenin to help differentiate distinguish deep fibromatoses from congeners. Formalin-fixed, paraffin-embedded sections from 21 lesions from 20 patients with deep fibromatoses were stained with monoclonal β-catenin antibody (Transduction Laboratories) and compared with low-grade fibromyxoid sarcoma (n = 12), leiomyosarcoma (n = 10), various other fibrosarcoma variants (n = 13, including 3 myofibrosarcomas, 3 sclerosing epithelioid fibrosarcomas, 5 low-grade fibrosarcomas, 1 classic fibrosarcoma arising in dermatofibrosarcoma protuberans, 1 inflammatory myxohyaline tumor/myxoinflammatory fibroblastic sarcoma), myofibroma/myofibromatosis (n = 12), nodular fasciitis (n = 11), and scars (n = 9). Nuclear and cytoplasmic staining was assessed. All 21 examples of deep fibromatosis displayed nuclear β-catenin (focal nuclear staining in one case to 90% staining). All other lesions tested (n = 67) lacked nuclear labeling for β-catenin, showing only cytoplasmic accumulation. β-Catenin immunohistochemistry separates deep fibromatosis from entities in the differential diagnosis, a finding that can be exploited for diagnosis. Most fibromatoses have diffuse nuclear staining although occasional examples only focally label.

Original languageEnglish (US)
Pages (from-to)653-659
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume29
Issue number5
DOIs
StatePublished - May 1 2005

Keywords

  • Fibromatosis
  • Leiomyosarcoma
  • Low-grade fibromyxoid sarcoma
  • Myofibroma
  • Myofibromatosis
  • Myofibrosarcoma
  • Nodular fasciitis
  • Scar
  • β-catenin

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

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