Myxoid intravascular fasciitis

Area of Science:

• Pathology
• Dermatopathology
• Soft Tissue Tumors

Background:

• Nodular fasciitis is a common benign soft tissue proliferation characterized by fibroblasts and myofibroblasts.
• Intravascular fasciitis is a rare variant of nodular fasciitis, typically found within blood vessels.
• Histological descriptions of intravascular fasciitis usually note a less prominent myxoid matrix compared to typical nodular fasciitis.

Observation:

• A case of intravascular fasciitis presented clinically as multiple nodules on the leg.
• Histopathological examination revealed spindle cell proliferation within a dermal vein.
• Prominent mucin deposition between spindle cells was confirmed by Alcian blue staining.

Findings:

• Immunohistochemistry showed spindle cells positive for vimentin, actin, and smooth muscle actin.
• The spindle cells were negative for keratin, S100 protein, desmin, CD31, and CD34.
• The combination of clinical presentation and histopathological features led to the diagnosis of myxoid intravascular fasciitis.

Implications:

• This case expands the histological spectrum of intravascular fasciitis, highlighting a myxoid variant.
• Accurate diagnosis is crucial for differentiating this benign entity from malignant soft tissue tumors.
• Understanding the myxoid variant aids in precise pathological classification and clinical management.