Intranodal palisaded myofibroblastoma of the supraclavicular region in an adolescent with an HDAC2 variant: a case report

Vollständiger Abstract

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Intranodal palisaded myofibroblastoma (IPM) is a rare benign mesenchymal tumor of lymph nodes that most often arises in the inguinal region. We report an 18-year-old woman with an incidentally detected left supraclavicular mass. Imaging showed a well-circumscribed hypervascular lesion, and core biopsy demonstrated a spindle-cell neoplasm for which low-grade malignancy could not be excluded. Complete excision revealed an intranodal spindle-cell proliferation with nuclear palisading, hemorrhage, compressed peripheral lymphoid tissue, and hyalinized fibers. The morphology and immunophenotype supported IPM. Targeted sequencing identified an HDAC2 p.V12Sfs * 8 variant, whereas no CTNNB1 variant was detected. Because no functional validation was performed, the biological significance of the HDAC2 variant remains uncertain. This case highlights IPM in an adolescent at an uncommon supraclavicular site and emphasizes careful pathological evaluation of spindle-cell lymph-node lesions.