Malignant fibrous histiocytoma

A 62-year-old patient presented with slow-growing blue-red tumor on his left forearm for around two years. A biopsy revealed the tumor was a rare malignant fibrous histiocytoma (MFH). The finger-like extensions of MFH in the fatty tissue are responsible not only for the high local recurrence rate, but also increase the metastatic potential and affect the prognosis. For this reason radical surgery with surgical margins of 2?C3 cm is absolutely required. After wide excision, the patient has been alive for years without evidence of local recurrence or distant metastasis.     

Malignant fibrous histiocytoma

A 74-year-old man presented with a malignant fibrous histiocytoma (MFH) on the lower leg. Wide local excision was performed and no recurrence has occurred to date. The pathological features which distinguish MFH from other sarcomas are now well denned and deserve wider recognition.     

动脉瘤样纤维组织细胞瘤

动脉瘤样纤维组织细胞瘤是皮肤纤维瘤的一种少见异型,组织病理特征为在纤维组织细胞瘤结构中出现含有血液的腔隙.其在临床上易误诊为黑素瘤、血管瘤等,因而鉴别诊断具有重要意义.     

Recurrent malignant fibrous histiocytoma with expression of cytokeratin.

A case of locally recurrent malignant fibrous histiocytoma was documented in a 70-year-old man. He first noticed a subcutaneous nodule forty years previously. The tumor was surgically removed four times during the last four years with local recurrence on every occasion. In the recurrent tumors, the tumor cells almost completely replaced the whole dermis and invaded skeletal muscles. They were composed of pleomorphic spindle cells arranged in a storiform pattern and bizarre histiocytic cells, which were present principally in the deeper portions of the tumor. Both types of tumor cells showed marked nuclear atypicality. In the primary tumor, surrounding a large necrotic area, spindle-shaped cells were arranged in a storiform pattern. These tumor cells exhibited only mild nuclear atypia. The recurrent tumor was strongly positive for vimentin and alpha-1-antichymotrypsin. Most tumor cells were also weakly positive for KL1, a monoclonal antibody for keratin. A Western-blot analysis revealed the presence of two bands (62 and 69 Kd) reacting with KL1 in the fractions which were obtained from the tumor according to the method for keratin extraction.     

Aneurysmal fibrous histiocytoma: an unusual variant of cutaneous fibrous histiocytoma

Aneurysmal fibrous histiocytoma (AFH) (Santa-Cruz DJ, Kyriakos M. Aneurysmal ('Angiomatoid') fibrous histiocytoma of the skin. Cancer 1981;47:2053-2061) is a distinct but poorly recognized clinicopathological variant of cutaneous fibrous histiocytoma (CFH) that may result from the slow extravasation of blood into the tumour. The resulting lesion can have a very different clinicopathological appearance resulting in diagnostic confusion. We describe a patient with an AFH that presented as a pigmented nodule on the foot and discuss clinical recognition and histological differentiation from other tumours.     

Palisading cutaneous fibrous histiocytoma

We report 6 cases of an unusual variant of cutaneous fibrous histiocytoma in which nuclear palisading is a prominent feature. The lesions were equally distributed between males and females with a widely variable age range. Half of the cases occurred on the digits. Histopathologically, the lesions were characterized by areas of nuclear palisading with formation of Verocay-like bodies in addition to the more typical features of the "fibrous" variant of cutaneous fibrous histiocytoma. The differential diagnostic features between these lesions and those of other tumors in which nuclear palisading is seen are discussed.     

Postirradiation malignant fibrous histiocytoma

A slowly growing, firm, asymptomatic tumor developed in the skin overlying the left scapula of a 72-year-old woman during a six-month period. Twenty-seven years earlier, she had radiation treatment to that site for an intraductal carcinoma of the left breast. The histopathologic diagnosis was malignant fibrous histiocytoma (MFH). The rarity of this late complication of radiation therapy is reflected by a few reports in the medical literature of cutaneous MFH as late radiation sequelae.     

Atypical cutaneous fibrous histiocytoma

We report seven cases of atypical cutaneous fibrous histiocytoma, which appears to be a variant of cutaneous fibrous histiocytoma (dermatofibroma). These patients are all middle-aged women (mean, 39 years old) with small nodules occurring on the trunk and limbs. The lesions are characterized by marked focal cellular atypia, the absence of mitoses, and xanthomatous changes in both mononuclear and giant cells--all found within a small dermal nodule (approximately 1 cm) separated from an acanthotic epidermis by a Grenz zone. Their benign nature is demonstrated by the absence of recurrence, even after 9 years follow-up time.     

Malignant fibrous histiocytoma of the scalp. Multidisciplinary treatment

BACKGROUND: Malignant fibrous histiocytomas (MFH) are uncommon in the skin, and even less frequent on the scalp. On the scalp they are often very difficult to excise and it is even more difficult to close the resulting wound. OBJECTIVE: To review all malignant fibrous histiocytomas diagnosed and treated in our Department during the past 6 years, and to describe the multidisciplinary procedure employed to treat one special case of aggressive malignant fibrous histiocytoma on the scalp that recurred twice. RESULT: Malignant fibrous histiocytomas represent 0.01% of malignant cutaneous tumors in our area. The immediate results after a multidisciplinary treatment performed on a recurrent malignant fibrous histiocytoma located on the scalp were excellent, but recurrence was observed 6 months later. Two years later we have also treated another case of MFH on the scalp. The same surgical technique was performed, but the patient received high-dose-methotrexate-based neoadjuvant chemotherapy (HD-MTX). One year later, this patient is still alive and no signs of recurrence have been detected. CONCLUSION: When malignant fibrous histiocytoma occurs on the scalp it must be treated immediately by means of an excision with a large peripheral edge of 2 cm from the visual or CAT limits of the lesion, since the first treatment must be definitive.     

Benign cellular fibrous histiocytoma with erosion of the phalanx

Fibrohistiocytic tumors are characterized by the presence of fibroblast like spindle cells and histiocytes. The benign fibrous histiocytoma (dermatofibroma, BFH) as well as the malignant dermatofibrosarcoma protuberans (DFSP) and the malignant fibrous histiocytoma (MFH) belong to this group. A recurrent painful, hard 2 cm tumor on the left hallux of a 54-year-old woman led to an erosion of the underlying phalanx. The patient had suffered from ingrown toenails for more than 10 years. Histologically there was a deep penetrating fibrohistiocytic tumor that grew in a storiform pattern with interspersed foam cells. The tumor was CD34 negative and mitoses were scarce. The diagnosis was benign cellular fibrous histiocytoma (BZFH). BZFH belong to the group of BFH with a high recurrence rate especially after incomplete removal. Damage to the underlying bone has not been reported so far.     

血管瘤样纤维组织细胞瘤

报告1例血管瘤样纤维组织细胞瘤.患者女,24岁.因左胫前出现无痛性紫红色皮下结节4年就诊.皮损组织病理检查:真皮下层可见肿瘤细胞团块,肿瘤主要由成纤维细胞样细胞和组织细胞样细胞组成,在肿瘤团块中可见数处不规则出血性裂隙和囊腔,但管周无内皮细胞.免疫组化染色示肿瘤细胞波形蛋白(vimentin)、平滑肌肌动蛋白(SMA)、上皮膜蛋白(EMA)和CD68阳性,而结蛋白(desmin)、S-100蛋白、CD31、CD34和Ⅷ因子相关抗原均阴性.结合临床表现、组织病理改变和免疫组化染色,诊断为血管瘤样纤维组织细胞瘤.     

Atypical fibroxanthoma/malignant fibrous histiocytoma

ABSTRACT: Atypical fibroxanthoma (AFX) is an unusual spindle cell tumor occurring on actinically damaged skin of the head and neck. Clinically, it is often confused with basal cell carcinoma, squamous cell carcinoma, or even melanoma. Although initially thought to be a diagnosis of exclusion histologically, newer immunostains have helped in the identification of AFX. Mohs micrographic surgery has been utilized for the treatment due to its tissue sparing ability along with lower recurrence rate.     

Cutaneous presentation of malignant fibrous histiocytoma

We have reviewed the clinical and pathological details of 10 patients with malignant fibrous histiocytoma (MFH) recorded in the diagnostic index of our pathology department computer between January 1983 and January 1986. There were seven males and three females in the series, age range of 55–82 years, average age 74 years. One patient had a lesion in the testis. Five presented with subcutaneous masses, three on the limbs, one on the neck and one on the upper back. Four patients presented with cutaneous lesions. In one, a mass arose in an area previously treated with radiotherapy. The remaining three had lower leg ulceration and there was a clear preceding history of varicose veins and ulceration in two, and a history of trauma to the affected leg in two.
All the tumours were of the pleomorphic/spindle cell histological variant except one, affecting the right calf, which had a myxoid pathology.
MFH is said to be the commonest soft tissue sarcoma of later life.¹ There are isolated reports of cutaneous tumours, especially in post-irradiated areas. To our knowledge there has been only one report of the tumour in relation to chronic ulceration.² Dermatologists should be aware of this important tumour and its modes of presentation.     

动脉瘤样皮肤纤维组织细胞瘤二例

临床资料 例1,女,50岁。主因右大腿外侧蓝褐色肿物5年、伴疼痛1年,于2010年1月28日到我院就诊。5年前患者右大腿外侧出现一绿豆大小的蓝褐色丘疹,无特殊不适。近1年来皮损扩大明显,并伴有疼痛感。体格检查：系统检查未见异常。皮肤科检查：右大腿外侧一蚕豆大小、隆起性蓝褐色肿物（图1a）,触之质软,有囊性感,有轻触痛。     

Aneurysmal (angiomatoid) fibrous histiocytoma

We report a patient with aneurysmal (angiomatoid) fibrous histiocytoma manifested clinically as a single firm subcutaneous nodule, diagnosed as an epithelial cyst. Histologically, the growth showed massive histiocytic proliferation and areas with a vascular component. The lesion was histologically mistaken for Kaposi's sarcoma.     

A case of malignant fibrous histiocytoma

A case of malignant fibrous histiocytoma is reported. Due to the histological features of cellular pleomorphism and myxoid degeneration seen also in other soft tissue sarcomas (rhabdomyosarcoma, liposarcoma), differential diagnosis was difficult. However, electron microscopic studies led to a distinct diagnosis of malignant fibrous histiocytoma.     

恶性纤维组织细胞瘤1例

报告1例恶性纤维组织细胞瘤。患者男,78岁,左胫前色素性结节10余年,近两年结节缓慢增大呈紫黑色斑块,无明显自觉症状。组织病理检查示,肿瘤中成分呈多形性表现,主要由增生的内皮细胞构成,部分细胞似成纤维细胞样交织排列呈游涡状,有些细胞似组织细胞样,可见形状怪异的多核巨细胞。