A more cellular spindled proliferation irregularly dissects through the denser (more pink, less cellular) fibroconnective tissue. The histology depends on the age of the lesion. Early lesions are cellular, composed of fascicles of myofibroblasts with plump vescicular nuclei. Later lesions are less cellular, more collagenized, and the myofibroblasts more tapered inactive-appearing nuclei.
The myofibroblasts have a variably wavy and plump spindled appearance.
Palmar fibromatosis (Dupuytren's contracture) are fibrous bands that develop on the palm or flexor aspect of the fingers. It is bilateral in 50% of cases (Folpe) and some patients may exhibit other superficial fibromatoses such as plantar fibromatosis (Ledderhose disease) and penile fibromatosis (Peyronie's disease). There is no association with deep fibromatoses, however.
Trisomy 7 or 8 have been described, and in contrast to desmoid fibromatosis, palmar fibromatosis do not have mutations of APC or beta-catenin (Fletcher, Folpe).
Mainly occurs in adults and the incidence increases with advancing age. There is a predilection for the male gender and those with Northern European ancestry. There is a controversial association with alcohol abuse, diabetes, epilepsy and trauma (Folpe, Fletcher). Presents as a nodule that becomes a fibrous band, leading to a flexion contracture, commonly of the fourth or fifth fingers (Folpe).
Fasciectomy is the key treatment. Local recurrence is common, especially if incompletely excised.
Fletcher CDM, ed. Diagnostic Histopathology of Tumors. 3rd Ed. Philadelphia, PA: Elsevier; 2007: 1550-1.
Folpe AL, Inwards CY. Bone and Soft Tissue Pathology: Foundations in Diagnostic Pathology Philadelphia, PA: Elsevier; 2010: 53.