Stromal fibrosis is the development of fibrous tissue in the stromal cells that make up an important part of the connective tissue. It can be identified on a biopsy of tissue from an area of interest or concern. The pathologist will be able able to identify an unusually high concentration of fibrous tissue among the cells, and can describe this as stromal fibrosis. She may also have other findings from the same examination.
On a biopsy report, this term can be frightening for patients to encounter, especially if it is not explained. Fibrosis in general usually occurs in response to inflammation, either chronic or recurrent. Over time, the repeated bouts of inflammation irritate and scar the tissue, causing buildups of fibrous tissue. If enough fibrous material develops, it can turn into stromal fibrosis. This finding can indicate the presence of underlying disease, poor response to treatment for inflammation, or something else, depending on other findings in the same examination.
Often, stromal fibrosis is benign in nature. A pathologist will note it because it is not expected, but it is not a cause for concern. The surrounding tissue should function like it normally does, and the stromal cells will continue to provide support. For example, if a patient's breast biopsy shows signs of stromal fibrosis, it means that the underlying tissues in the breast are fibrous, but doesn't indicate the presence of cancer or anything else. The pathologist might also find small cysts, evidence of fibrocystic breast disease.
The development of fibrosis may be a cause for concern with other kinds of cellular changes. A pathologist could identify signs of malignancy with the fibrosis, for instance. The fibrosis may be the result of inflammation and irritation caused by disease, like a cancerous tumor. A doctor may request medical imaging studies and other tests if the pathologist believes the stromal fibrosis is indicative of a medical problem. The doctor can use information from these tests to determine if the patient needs treatment.
A finding of stromal fibrosis may result in nothing other than a recommendation to monitor the area for signs of tissue changes. The patient may not need any medical intervention, and the fibrous tissue may never turn into a cause for concern. In other cases, patients may need medications, surgery, and other treatment options to address an ongoing disease process. A pathologist can reassess the tissue later to see how well the patient responded to treatment.