Subtitle: Elastofibroma (dorsi): subscapular site, elderly patients, chenille bodies (beads on a string elastic fibres), elastic stains, benign behaviour, differential diagnosis and 6 MCQs.
Author: PathologyMCQ Editorial Board
Category: Soft Tissue Pathology
Last Updated: October 2026
Read Time: 4 minutes
At-a-Glance
- Benign fibroelastic pseudotumour, classically subscapular (elastofibroma dorsi), often bilateral.
- Older adults, more often women; linked to repetitive mechanical friction.
- Histology: paucicellular collagen, fat and thick, fragmented elastic fibres.
- Chenille bodies: elastic fragments lined up like beads on a string.
- Elastic stains (Verhoeff–van Gieson, orcein) confirm; excision is curative.
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Histology
Elastofibroma is an ill-defined, rubbery mass of grey-white fibrous tissue streaked with yellow fat. Microscopically it shows hypocellular collagen, entrapped mature adipose tissue and numerous thick, eosinophilic, fragmented elastic fibres. The fragments line up in a linear, globular fashion, creating a “beads on a string” appearance known as chenille bodies; cross-sections can look like flower-like or serrated discs. The bland fibroblasts are CD34 positive.
Differential Diagnosis
| Lesion | Key features |
|---|---|
| Elastofibroma | Subscapular, elderly; abundant abnormal elastic fibres (chenille bodies) |
| Nuchal-type fibroma | Posterior neck; dense collagen entrapping fat and nerves; few elastic fibres |
| Gardner fibroma | Children, FAP; nuclear beta-catenin |
| Desmoplastic fibroblastoma (collagenous fibroma) | Hypocellular, stellate cells; FOSL1 expression |
| Desmoid fibromatosis | Cellular fascicles, infiltrative; nuclear beta-catenin |
| Fibrolipoma | Mature fat with fibrous septa; normal elastic fibres |
Test Yourself: 6 MCQs
Elastofibroma: 6 MCQs
Site, chenille bodies, stains and behaviour, with instant explanations.
More practice: the question banks →
Exam Pearls
- Subscapular + elderly + elastic fibres = elastofibroma.
- Chenille bodies = beads on a string elastic fragments.
- Confirm with Verhoeff–van Gieson.
- Benign pseudotumour; excision is curative.
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References
- WHO Classification of Tumours Editorial Board. Soft Tissue and Bone Tumours. 5th ed. IARC; 2020.
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