Intranodal myofibroblastoma is rare benign spindle cell neoplasm of lymph node, first described in 1989, that can be confused with other spindle cell tumor. Immunohistochemical and ultrastructural analysis are essential for a correct diagnosis. We reported a typical case of intranodal myofibroblastoma in a 72-year-old female, which is, to our knowledge, the 64th case described in literature. Myofibroblastic differentiation of the lesion was revealed by immunohistochemical positivity for smooth-muscle actin and vimentin and negativity for desmin and S100 protein. On ultrastructural examination the neoplasm showed the presence of cytoplasmic myofilaments with dense bodies and attachment plaques or hemidesmosome-like structures. We also review the literature in order to delineate the clinical and pathological features of this rare neoplasm.