DFSP vs DF (dermatofibrosarcoma protuberans vs dermatofibroma): pathology dermatology dermpath

Excerpt from "Dermatopathology Pearls for Head & Neck / Oral & Maxillofacial Pathologists" (full video: kikoxp.com/pos.... Presented at the American Academy of Oral & Maxillofacial Pathology (AAOMP) 2021 Annual Meeting (Virtual), May 2021.
If you are a DFSP patient or family member reading this, please see my DFSP FAQ video which is aimed at patients and non-medical family members ( • DFSP patient questions... ).
Also, please consider joining one of these DFSP patient support groups on Facebook:
/ dfspsupport
/ 743419279047310
/ 26592523481
A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/pos... (dermpath) & kikoxp.com/pos... (bone/soft tissue sarcoma pathology).
Please check out my Soft Tissue Pathology & Dermatopathology survival guide textbooks: bit.ly/2Te2haB ‬
This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.
Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.
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[@JMGardnerMD]

Excerpt from "Dermatopathology Pearls for Head & Neck / Oral & Maxillofacial Pathologists" (full video: kikoxp.com/posts/6020). A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

[@o2bn2it]

Thank you Dr Gardner for a clear concise explanation of the histocytology of DFSP, a new diagnosis for me.

[@GörkemGökçekuyu]

Dear Dr. Gardner, Based on the data mentioned below, can a definitive diagnosis of DFSP be made? Are there any other data that need to be considered apart from these? CD34 = Diffuse and strong & CDK4 = Focally in between & Desmin and Actine = Focal and weak & Mdm-2 and S-100 = Negative & "Ki-67 8% Regards

[@rahmaabdulkadir1196]

Thank you very much .you are doing great work,please keep posting these short clip.

[@yeterartkyeter9031]

Is DFSP growing faster than DF? For example; Will DFSP and DF grow at the same rate in 5 years, will the shape change be the same? I am curious.

[@mariavictorialaborie560]

Total genius! Thank you so much

[@zeynepmutlu6766]

Sir, C34 is an important indicator in DFSP, but other than that, what data does DFSP show us, what data does DF show? I look at the slides, but unfortunately I cannot understand the videos clearly because they are not in my language :((

[@Jam-zg2co]

thank you so much. I have a question: Does DFSP contain histiocytes? I did not see one . so why do they classify this tumour with Fibrohisticytic category ?

[@JMGardnerMD]

No dfsp doesn’t have histiocytes. “Fibrohistiocytic” is a historical term we have used in pathology and continue to use for a variety of mostly unrelated spindle cell tumors, but it’s not very accurate. There’s no such thing as a “fibrohistiocyte”. Most things in this category are probably not fibroblastic or myofibroblastic. Some of them do contain histiocytes as intermixed background cells (like dermatofibroma, for example).

[@Jam-zg2co]

@@JMGardnerMD thank you much

[@CeydaAkn-fz4qr]

When CD34 and Vimentin are positive is it definitely DFSP? Could these values ​​also be positive in DF?

[@kdemlimezun5684]

Considering that I had DF, a local surgical procedure was performed on my arm, but it was stated that it had spread to the joints during the procedure. So there was only one on the skin, but it was said that there were more than one under the skin. Can DF spread this way, or is this DFSP?

[@JMGardnerMD]

Spreading “to the joints” isn’t something I’ve ever seen for DF or DFSP. I don’t know exactly what they mean by that. Was the tumor tissue removed during surgery sent to the pathology lab? What did the pathology report say? The pathologist is the final word in what the diagnosis is. Best wishes for health and healing.

[@kdemlimezun5684]

@@JMGardnerMD The doctor stated that small round tissues were removed from the joints in addition to the tumor during the surgery, and that tissue was also found in the joints. Yes, the tumor was sent to the pathology laboratory. DFSP was seen in the report, but the doctor thought that there was no DFSP in the tumor and the tumor was sent to a different pathology laboratory. The doctor stubbornly thinks it's DF. This situation is starting to scare me, I don't know what to do. Thank you for your answer sir.

[@CeydaAkn-fz4qr]

Hi teacher. What is the error rate in pathology tests? For example; Is it possible to see DFSP in one pathology report and DF in a different pathology report for the same tumor? Are pathology results always accurate?

[@JMGardnerMD]

Pathology is not a perfect science there is subjectivity to interpretation of biopsy samples. Yes it is possible for disagreement between pathologist where one pathologist may think a tumor is dermatofibroma and the other may look at the same slide and think it is DFSP. The most important thing is having an experience pathologist. Look at the slides. Someone who has experience in skin pathology, and soft tissue tumors ideally. CD34 can be very helpful in certain situations because it is usually strongly positive in DFSP and mostly negative in DF. However, there can be some exceptions and interpretation can be tricky sometimes. Additionally, many other tumors are positive for CD34. So CD34 staining by itself does not prove that a tumor is DFSP. And vimentin is a useless stain that is not diagnostically helpful for spindle cell tumors. Some pathologist use it, particularly if they were trained in the older days when they were a fewer stains available. But I never use it for spindle cell tumors in my practice. Detailed explanation of why I don’t like vimentin: kikoxp.com/posts/4771

[@CeydaAkn-fz4qr]

Thank you for all the explanations sir, I will take a look

[@sarahjun8843]

Dr. Gardner, Hoping you could help me with some questions - could a cellular DF ever turn into a DFSP? I’ve been diagnosed with cellular DF but the growth keeps growing and is very irritated. Wondering if it can change?

[@JMGardnerMD]

No, despite the similar sounding name, dfsp is totally unrelated to dermatofibroma. Cellular DF can grow back and can be irritated (but it’s extremely rare for it to act more aggressively than that). Was yours removed completely and then it grew back? Or did they just take a small portion for the diagnosis but not remove the rest of it? That latter situation is where I most often see cellular DF keep growing. When a DF keeps growing or is causing discomfort, it can be removed by a simple surgical excision procedure. Please be sure to see your dermatologist as soon as you can so they can examine the lesion and review the pathology results again and then help you decide what is the best course of action. But in the meantime try not to worry or lose sleep over this. It’s common for cellular dermatofibroma to keep growing and to be irritated. Best wishes for health and healing.

[@muslimalhamdulillah3739]

Thank you

[@ahmadnawaz8308]

What is recurring rate?

[@znrsmsaa3655]

Thanks alot

[@saeedhesaraki8796]

Great

[@Thesilentwolf7610]

Does all Dermatofibroma dimple ? I went to a dermatologist and said mine isn't cancerous but didn't say it was a dermatofibroma. Mine doesn't dimple and it is pink slightly raised but small.

[@JMGardnerMD]

No, not all dermatofibromas make a dimple.

[@Thesilentwolf7610]

@@JMGardnerMD Wow thank you for answering back ! I'm convinced mine is dermatofibroma as it always looked pink no matter how many times I apply oil and skin products, my derma said it's not cancerous but its a cyst, still not convinced its a cyst as the pink never went away.

[@mdimranalam3429]

@@JMGardnerMD dfsp benign

[@lullabybaby5596]

Thank you