Abstract
Background: The category of the “stromal tumors of the lower female genital tract” encompasses a wide spectrum of lesions with variable heterogeneity, which can be nosologically classified on the basis of their morphologic and immunohistochemical profiles as deep (aggressive) angiomyxoma (DAM), cellular angiofibroma (CAF), angiomyofibroblastoma (AMFB) or myofibroblastoma (MFB). Despite the differential diagnosis between these entities being usually straightforward, their increasingly recognized unusual morphological variants, along with the overlapping morphological and immunohistochemical features among these tumours, may raise serious differential diagnostic problems. Methods and Results: The data presented in the present paper have been retrieved from the entire published literature on the PubMed website about DAM, CAF, AFMB and MFB from 1984 to 2021. The selected articles are mainly represented by small-series, and, more rarely, single-case reports with unusual clinicopathologic features. The present review focuses on the diagnostic clues of the stromal tumours of the lower female genital tract to achieve a correct classification. The main clinicopathologic features of each single entity, emphasizing their differential diagnostic clues, are discussed and summarized in tables. Representative illustrations, including the unusual morphological variants, of each single tumour are also provided. Conclusion: Awareness by pathologists of the wide morphological and immunohistochemical spectrum exhibited by these tumours is crucial to achieve correct diagnoses and to avoid confusion with reactive conditions or other benign or malignant entities.
Highlights
The category of the “stromal tumours of the lower female genital tract” covers a wide spectrum of lesions with variable morphological and immunohistochemical heterogeneity
It is crucial to distinguish deep (aggressive) angiomyxoma (DAM) from the others due to its relatively high risk of local recurrence. Differential diagnosis between these entities is usually straightforward if the typical morphology and clinicopathologic features are encountered
The data presented in the present paper have been retrieved by the entire published literature on the PubMed website about DAM, cellular angiofibroma (CAF), AFMB and MFB from 1984 to 2021
Summary
The category of the “stromal tumours of the lower female genital tract” covers a wide spectrum of lesions with variable morphological and immunohistochemical heterogeneity They arise from the specialized, hormonally responsive stroma of the lower female genital tract, and, based on morphological and immunohistochemical features, at least four tumour entities can be nosologically recognized: (i) deep (aggressive) angiomyxoma (DAM); (ii) cellular angiofibroma (CAF); (iii) angiomyofibroblastoma (AMFB) and (iv) myofibroblastoma (MFB) [1,2]. Among these tumours, it is crucial to distinguish DAM from the others due to its relatively high risk of local recurrence. Conclusion: Awareness by pathologists of the wide morphological and immunohistochemical spectrum exhibited by these tumours is crucial to achieve correct diagnoses and to avoid confusion with reactive conditions or other benign or malignant entities
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