Malignant fibrous histiocytoma

Seven cases of malignant fibrous histiocytoma are reported. Two patients had tumour involving the scrotum and small-gut mesentery, which are unusual primary sites, while three others with pulmonary metastases are alive five years since the appearance of these metastases. A review of the histogenesis, biological behaviour and the treatment of these uncommon tumours suggests that the prognosis is good even in the presence of advanced local or metastatic disease. Radiotherapy controlled the primary lesion in one patient and was effective in treating pulmonary metastases in three, suggesting that these tumours do show a response to radiotherapy. The prophylactic use of radiotherapy and chemotherapy awaits further evaluation.     

Malignant fibrous histiocytoma tumor cells resemble fibroblasts

The malignant fibrous histiocytomas (MFHs) are a histologically heterogeneous group of sarcomas that have been postulated to be derived from, or have the capacity to differentiate into, histiocytes. To determine whether MFH tumor cells actually express the features of histiocytes, i.e., bone marrow-derived cells of monocyte-macrophage lineage, we studied the antigenic and enzymatic phenotype of 13 MFHs in situ using frozen and plastic sections, respectively. Five pleomorphic three fibrous, two myxoid, two giant cell, and one histiocytic MFH were studied. While tumor cells in 12 of 13 cases were positive for HLA-A,B,C, tumor cells in all cases failed to express antigens present on bone marrow-derived macrophages, i.e., leukocyte common antigen (L3B12), HLA-DR, Leu-M3, and Leu-3a. Interestingly 8 of 13 cases were positive for CALLA. Although nonspecific, this may prove useful in differential diagnosis. Enzyme histochemistry demonstrated that tumor cells in 9 of 13 cases were positive for membrane 5' nucleotidase (5'N+). Four of these were also alkaline phosphatase positive (ALKP+). All cases were either negative or weakly positive for acid phosphatase (ACIDP) and alpha-naphthyl acetate esterase (ANAE). Tumor cells were unreactive for alpha-naphthyl butyrate esterase (ANBE) and adenosine triphosphatase (ATP). These findings indicate that MFH tumor cells do not express the enzymatic profile of cells of monocyte/macrophage lineage which are membrane 5'N-/ALKP- and ACIDP+/ANAE+/ANBE+/ membrane ATP+. In fact, these data suggest a similarity to fibroblasts which are membrane 5'N+, variably ALKP+, weakly ACIDP+/ANAE+, and ANBE-/membrane ATP-. Osteoclast-like giant cells present in two cases did express a histiocytic phenotype, suggesting that they are reactive elements not derived from admixed tumor cells. These results suggest that MFHs are primitive mesenchymal neoplasms, most likely sarcomas composed of poorly differentiated fibroblasts, and are unrelated to true histiocytic neoplasms.     

软组织恶性纤维组织细胞瘤的治疗(附12例报告)

发生于软组织的恶性纤维组织细胞瘤１２例，平均年龄６１．９岁，平均随访２９个月。本病与发生在骨组织的恶性纤维组织细胞瘤不同，病理学还可分为席纹样－多形性型、粘液样型、巨细胞型、黄色肉芽肿型。本病局部广泛切除可以得到较好的治疗，综合治疗特别放疗及化疗药物的应用，对减少复发，治疗转移有一定的疗效。     

Malignant fibrous histiocytoma of spermatic cord.

Malignant fibrous histiocytomas are very rare, particularly those related to urogenital organs. We report herein the third known case of this entity involving the spermatic cord. Summary of the previously reported 2 cases is given with recent follow-up. Prognosis is poor.     

Malignant fibrous histiocytoma of bone

Malignant fibrous histiocytoma is a rare primary bone tumor, and there have been conflicting reports on its grades of malignancy. We are describing the cases of eight patients who were seen between 1977 and 1982. Four had pulmonary metastases and five, involvement of the lymph nodes. Five patients had a high level of serum alkaline phosphatase. None of the patients had a pathological fracture, an associated bone infarct, or Paget's disease. Seven of the eight patients died within one year after diagnosis.     

Malignant fibrous histiocytoma of prostate

A prostatic tumor removed suprapubically in a sixty-three-year-old man was found to be a malignant fibrous histiocytoma. Various aspects of prostatic sarcomas and malignant fibrous histiocytomas are considered.     

Malignant fibrous histiocytoma of bone

Malignant fibrous histiocytoma of bone is a highly malignant neoplasm similar to that found in soft tissues. It accounts for at least 5% of all primary malignant bone tumors. The majority of lesions are primary, but some arise in preexisting benign lesions. Definitive diagnosis is made on histologic examination, a storiform arrangement of spindly tumor cells being the classic finding. Radical resection combined with preoperative and postoperative chemotherapy is the treatment of choice.     

Malignant fibrous histiocytoma mimicking pulmonary embolism.

A rare case of malignant fibrous histiocytoma occurring in the pulmonary artery is reported. Such primary pulmonary artery sarcomas may have the diagnosis suggested by angiography or echocardiography; radiographically and in perfusion-ventilation scanning their usual unilateral origin (with later spread) and the persistence of the perfusion defect are among the features normally distinguishing them from thromboembolism.     

Malignant fibrous histiocytoma of the pulmonary artery.

A patient is reported whose symptoms and clinical features were interpreted as pulmonary embolism. However, the ultimate diagnosis was malignant fibrous histiocytoma of the pulmonary artery, which was made evident at operation. Although extremely rare in the early medical literature, primary sarcoma of the pulmonary artery has been reported more frequently during the last decade. This patient may provide further insight into the clinical, diagnostic, and therapeutic features of primary sarcomas of the pulmonary artery.     

Malignant fibrous histiocytoma in the skull--case report.

A 45-year-old male presented with a large calvarial mass caused by a malignant fibrous histiocytoma arising primarily from the frontal bone and extending into the intracranial space. Magnetic resonance imaging revealed a well-demarcated, mottled enhanced bulky tumor with several low-signal separations. He underwent extensive tumor and bone removal, followed by radiation therapy. Histological examination showed pleomorphic spindle cells in a storiform pattern. The tissue stained positive for alpha-1-antitrypsin and alpha-1-antichymotrypsin by immunohistochemical techniques.     

Malignant fibrous histiocytoma of the trachea

We experienced a rare case of malignant fibrous histiocytoma (MFH) arising in the trachea. A 24-year-old man with severe dyspnea had a well-defined mass in the cervical trachea on chest X-ray examination. Chest computed tomography showed a 2.0-cm diameter mass originating in the right-posterior wall of the trachea. The tumor occupied over 90% of the lumen. A radical excision of the tumor (tracheal resection) with tracheal plasty was performed. The microscopic diagnosis was MFH. The patient remains well, without evidence of recurrence, 3 months after surgery.     

Malignant fibrous histiocytoma of the pancreas

A case of fibrous histiocytoma of low grade malignancy arising from the uncinate lobe of the pancreas is reported. This is an unusual site for these extremely rare tumours. Survival up to 4 years has been achieved in our patient following surgical resection.     

Malignant fibrous histiocytoma of the foot

The author describes a malignant tumor presenting in the hallux of a middle-aged Caucasian male. Clinical and histologic characteristics are portrayed. Comparison with similar tumors, as well as differentiation among the five subtypes, is reported.