Colon tumor
Mesenchymal tumors
Reactive nodular fibrous pseudotumor

Author: Raul S. Gonzalez, M.D. (see Authors page)

Revised: 8 August 2017, last major update August 2017

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: reactive nodular fibrous pseudotumor
Cite this page: Reactive nodular fibrous pseudotumor. PathologyOutlines.com website. http://pathologyoutlines.com/topic/colontumorreactivenodular.html. Accessed November 19th, 2017.
Definition / general
Essential features
  • Benign fibroinflammatory mass more common in men
  • Stains for AE1 / AE3, CD117 and muscle specific actin
  • Does not appear to recur
Sites
  • Usually arises in mesentery; may involve colon or small bowel
Etiology
Clinical features
  • Usually occurs in patients aged 40 - 60; more common in men
  • Associated with prior abdominal surgery
  • Can cause acute abdominal pain but sometimes discovered incidentally
Case reports
Treatment
  • Complete resection appears curative
Clinical images

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Protruding lesion on back wall of gastric cardia

Gross description
  • Solitary or multiple tumors, usually involving outer wall of small intestine or colon
  • Firm, tan white, well circumscribed
  • Usually around 6 cm but may measure up to 20 cm
Gross images

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Cut surface of lesion

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Excised specimen in cut section

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Fibrotic nodules in pouch of Douglas

Microscopic (histologic) description
  • Mildly to moderately cellular lesion composed of stellate or spindled fibroblasts arranged haphazardly or in intersecting fascicles
  • Stroma rich in collagen (wire-like, keloidal or hyalinized)
  • Sparse intralesional mononuclear cells and peripheral lymphoid aggregates usually present
  • May have infiltrative borders
Microscopic (histologic) images

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Images contributed by Raul S. Gonzalez, M.D..
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Low power

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Intermediate power

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Interaction with adjacent fat

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Entrapped nerves

Negative stains
Molecular / cytogenetics description
  • No substitutions, deletions or insertions in exons 9 or 11 of KIT gene
Differential diagnosis
Board review question #1
    Which of the following abdominal lesions stains positive for CD117 by immunohistochemistry?

  1. Desmoid fibromatosis
  2. Inflammatory myofibroblastic tumor
  3. Reactive nodular fibrous pseudotumor
  4. Retroperitoneal fibrosis
  5. Sclerosing mesenteritis
Board review answer #1
C. Reactive nodular fibrous pseudotumor