Intracisternal Collagen Fibrils in Proliferative Fasciitis and Myositis of Childhood

During ultrastructural examination of a difficult to diagnose tumor, short spacing collagen fibrils (periodicity of banding, approximately 43.2 nm) and native collagen fibrils (periodicity of banding, approximately 53 nm) were found in dilated and vacuolated cisternae of rough endoplasmic reticulum and the perinuclear cistern. Original diagnoses from several histopathologists included alveolar soft part sarcoma, malignant fibrous histiocytoma, atypical fibroxanthoma, and myogenic tumor. The finding of intracisternal collagen (which is but a variety of intracellular collagen) led to the conclusion that this was a fibroblastic neoplasm. This, plus a review of the histologic findings, led to the diagnosis of proliferative fasciitis and myositis of childhood.