Case 33:Case history and
images:
Elastofibroma is a benign slowly progressive reactive lesion involving
abnormal elastogenesis.
It was first reported by Jarvi and Saxen in 1959 and published in 1961.
The lesion usually occurs in elderly patients and is relatively more
common in females. Most cases are unilateral.
Bilateral involvement is
present in about 10% of all cases.
The patient usually gives long history
of manual labour.
Elastofibroma is usually located in the lower subscapular area and is
probably caused by friction between the inferior edge of the scapula and
the underlying chest wall.
Cases have also been reported in the deltoid muscle, hip, thigh and
stomach.
Histologically, the lesion is characterized by an admixture of collagenous
fibrous bands and elastic fibres. Elastin stains reveal branched or
unbranched fibres with irregular serrated margins or fibres arranged in
globoid aggregates.
Electron microscopic studies revealed that the fibres consisted of
granular aggregations of electron dense material along a central core
surrounded by an amorphous matrix containing microfibrils. The collagen
deposited in this disease is a mixture of Type I, II and III.
According to some authors it has been assumed there is an underlying
genetic disposition or inherent enzymatic defect.
This benign reactive lesion has no tendency to recur and is usually
treated by surgical excision.
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