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Intranodal palisaded myofibroblastoma (IPM) is a rare lymph node lesion that has been recognised as an entity since 1989, initially having been known by different names, including ‘solitary spindle cell tumour with myoid differentiation of the lymph node’1 and ‘intranodal hemorrhagic spindle cell tumour with amianthoid fibres’.2 More than 50 cases have now been described, the majority of which have involved inguinal lymph nodes. The tumour is slightly more common in men and occurs over a wide age range (19–71 years).3 We report another case and discuss the nature, nomenclature and differential diagnosis of this entity.
A 74-year-old man presented with a 2-year history of a lump in the right groin, which had recently increased in size. On examination it was found to be firm, mobile and non-pulsatile. There was no surrounding inguinal lymphadenopathy. An ultrasound scan revealed a focal solid area (2×2 cm) of mixed echogenicity with some vascularity. Possible differential diagnoses were thought to be fat necrosis, calcifying epithelioma or epidermal cyst. The mass was excised and macroscopically it was a smooth grey nodule, 30 mm in maximum dimension, with a solid fibrous cut surface that appeared slightly gelatinous. Microscopy showed a tumour arising …