DERMATOPATHOLOGY DIAGNOSIS Benign Lesion on the Posterior Aspect of the Neck Nikoleta Brankov, BS; Brian Moore, MD; Kate Messana, DO; Melissa Piliang, MD copy A B H&E,Figure original 1. magnificationH&E, original magnification×4. Reference × 40.bar H&E,Figure original 2. magnification H&E, original ×magnification20. Reference × 40.bar denotes 500 μm. denotesnot 100 μ m. Do The best diagnosis is: a. dermatofibroma b. nuchal-type fibroma c. sclerotic fibroma d. solitary fibrous tumor CUTIS e. spindle cell lipoma PLEASE TURN TO PAGE 351 FOR DERMATOPATHOLOGY DIAGNOSIS DISCUSSION Ms. Brankov is from Loma Linda University School of Medicine, California. Drs. Moore, Messana, and Piliang are from the Departments of Dermatology and Pathology, Cleveland Clinic, Ohio. The authors report no conflict of interest. Correspondence: Nikoleta Brankov, BS, Loma Linda University School of Medicine, 24570 Stewart St, Loma Linda, CA 92354 (
[email protected]). 348 CUTIS® WWW.CUTIS.COM Copyright Cutis 2016. No part of this publication may be reproduced, stored, or transmitted without the prior written permission of the Publisher. Dermatopathology Diagnosis Discussion Nuchal-Type Fibroma uchal-type fibroma (NTF) is a rare benign small nerves (quiz image A). Collagen bundles are proliferation of the dermis and subcutis asso- thickened with entrapment of adipose tissue without ciated with diabetes mellitus and Gardner increased cellularity (quiz image B). S-100 staining N 1,2 syndrome. Forty-four percent of patients with NTF can show the entrapped nerves. have diabetes mellitus.2 The posterior aspect of the Similar to NTF, sclerotic fibroma is a firm der- neck is the most frequently affected site, but lesions mal nodule with histologic examination usually also may present on the upper back, lumbosacral demonstrating a paucicellular collagenous tumor.