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The myofibroblast and its tumours: a review
  1. Brian Eyden (brian.eyden{at}christie.nhs.uk)
  1. The Christie, Manchester, United Kingdom
    1. S Sankar Banerjee (liz.ryan{at}christie.nhs.uk)
    1. The Christie, Manchester, United Kingdom
      1. Patrick Shenjere (patrick.shenjere{at}christie.nhs.uk)
      1. The Christie, Manchester, United Kingdom
        1. Cyril Fisher (cyril.fisher{at}rmh.nhs.uk)
        1. Royal Marsden Hospital NHS Foundation Trust, United Kingdom

          Abstract

          Tumours and tumour-like lesions of myofibroblasts may present diagnostic difficulty because of their rarity and because of uncertainties in identifying the myofibroblast. The objectives of this review are to provide a definition of the myofibroblast, and an account of its biology for facilitating an understanding of the cell and of myofibroblastic lesions; and to describe, in the context of common diagnostic problems, the features of benign and malignant myofibroblastic lesions. The main characteristics of the myofibroblast include a spindled or stellate morphology, immunostaining for α-smooth-muscle actin and the extra domain A variant of cellular fibronectin, and an ultrastructure of rough endoplasmic reticulum, peripheral contractile filaments and the cell-to-matrix junction known as the fibronexus. On this basis, lesions traditionally regarded as myofibroblastic are shown to vary in their level of differentiation, and some appear to be smooth-muscle rather than myofibroblastic. Immunohistochemistry and electron microscopy, used together, are emphasised as being important for maximum diagnostic confidence in some myofibroblastic lesions.

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