Soft tissue
Fibroblastic / myofibroblastic tumors
Cellular angiofibroma

Author: Komal Arora, M.D. (see Authors page)

Revised: 15 August 2016, last major update July 2012

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Cellular angiofibroma

Cite this page: Cellular angiofibroma. website. Accessed October 26th, 2016.
Definition / General
  • Benign, highly cellular tumor of vulva and scrotum / inguinal region with prominent blood vessels
  • Also called angiomyofibroblastoma-like lesion
  • First described in 1997 (Am J Surg Pathol 1997;21:636)
  • Related to spindle cell lipoma and mammary-type myofibroblastoma, with morphological variations dependent on anatomic location (Mod Pathol 2011;24:82)
  • In women, may arise from hormone receptor positive mesenchymal cells in lower female genital tract (Histopathology 2004;45:360)
Clinical Features
  • Rare; usually ages 40+ years
  • Extragenital cases have similar features (APMIS 2007;115:254)
Case Reports
Gross Description
  • Vulvar lesions are usually up to 3 cm, male lesions may reach 14 cm
  • Well circumscribed nodules with soft to rubbery, gray-pink-brown cut surface
Micro Description
  • Well circumscribed, variable pseudocapsule
  • Cellular tumor with fascicles or haphazard pattern
  • Bland spindle cells with scant, lightly eosinophilic cytoplasm with ill defined borders, oval to fusiform nucleus
  • May be epithelioid
  • Prominent small to medium-sized vessels with hyaline fibrosis in walls
  • Vessels may have degenerative changes of fibrin thrombi, intramural inflammation, hemosiderin
  • Some (usually 5% or less) adipose tissue present in 50%
  • Stroma is usually fine collagenous fibers
  • Scattered mast cells are common
  • Female lesions may have brisk mitotic activity, usually absent/rare in males
  • Occasional atypia or sarcomatous transformation (Am J Surg Pathol 2010;34:707)
  • No necrosis, no atypical mitotic figures
Micro Images

Images hosted on other servers:

Various images

Recurrent tumor


Images hosted on Nature servers:

Occasional features

Typical features of CAF

Malignant cases


Positive Stains
Negative Stains
Molecular / Cytogenetics Description
Differential Diagnosis
  • Aggressive angiomyxoma: usually large and deep, hypocellular, infiltrative margin, desmin+
  • Angiomyofibroblastoma: less uniform cellularity, smaller vessels, usually desmin+
  • Leiomyoma: spindled cytoplasm, actin+, desmin+
  • Perineurioma
  • PHAT
  • Solitary fibrous tumor: hyper- and hypocellular areas, prominent staghorn vessels, hyalinized collagen CD34+