Deep benign fibrous histiocytoma is a benign soft tissue tumor occurring deep below the skin in 90% of the cases. We report a 64yearold man who presented with a fewmonths history of. It arises from the tissue histiocyte and generally behaves in a benign fashion. Lipidfilled cells may be conspicuous and occasionally are the major component. Angiomatoid fibrous histiocytoma is an uncommon, lowgrade malignant soft tissue tumor of uncertain histogenesis. Variants of dermatofibroma a histopathological study. It is otherwise known as epithelioid fibrous histiocytoma and epithelioid dermatofibroma. Histopathologic investigation of the resected tumor showed the. Aneurysmal benign fibrous histiocytoma of the skin bal a. Aug 24, 2018 deep benign fibrous histiocytoma is a benign soft tissue tumor occurring deep below the skin in 90% of the cases. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. The development of immunohistochemical techniques and electronic microscopy during the past thirty years has allowed to discriminate between malignant and benign forms, consequently benign fibrous histiocytoma bfh became a clinical entity, although many synonyms are still used 1,5,6. The management in this location can be challenging, involving tumour resection and metacarpal reconstruction.
Benign fibrous histiocytoma is a mesenchymal tumor that usually has a benign behavior and rarely leads to metastasis. There is a predilection for dermatofibroma to develop on the extremities, and particularly on the lower extremities of young adults. The mean age of these 23 patients was 39 years with no. Pathology outlines deep benign fibrous histiocytoma. Made up of a mixture of fibroblastic and histiocytic cells, collagen and blood vessels. Angiomatoid fibrous histiocytoma afh is a rare soft tissue neoplasm of intermediate rarely metastasizing biologic potential and uncertain differentiation, which predominantly arises superficially in the deep dermis and subcutis of the extremities of children and young adults.
Subcutaneous benign fibrous histiocytoma of upper eyelid. Although, the precise underlying etiology and mechanism for the development of this skin pathology is not well known, it is believed to be a neoplastic process owing to. Benign fibrous histiocytomas bfh of the skin are common lesions, although they only rarely involve the oral mucosa. Fibrous histiocytoma is of 2 types which includes benign and malignant. Variable hemosiderin, multinucleated giant cells, chronic. Dec 25, 2001 is cutaneous benign fibrous histiocytoma dermatofibroma a reactive inflammatory process or a neoplasm. Plexiform rays of fibrous tissue extending into fat.
Bfh is one of the most common tumors of the superficial and deep soft tissues. Alk rearrangement and overexpression in epithelioid fibrous. The authors present a case of bfh involving the second metacarpal bone. Pathology of fibrous histiocytoma dermatofibroma dr. Printable deep fibrous histiocytoma surgical pathology.
Neoplasm with features of usual dermal fibrous histiocytoma but occuring in subcutaneous or deep soft tissue. What is fibrous histiocytomatypescausestreatmentsurgery. A huge benign fibrous histiocytoma arising from the renal. Superficial portions of the tumor were well differentiated, exhibiting spindled and ovoid cells with scant. Zimmerman commented on the histopathology of orbital fibrous histiocytoma, but did not include any case protocols. Bland cytology vesicular nuclei with small nucleoli. We report a 64yearold man who presented with a fewmonths history of dull pain in the right. The benign fibrous histiocytoma bfh is a mesenchymal tumour that has been described as a benign neoplasm composed of fibroblasts and histiocytes arising in the cutaneous soft tissues.
Epithelioid benign fibrous histiocytoma, also known as epithelioid cell histiocytoma, has traditionally been considered a morphologic variant of cutaneous fibrous histiocytoma dermatofibroma. Only 23 previous cases of conjunctival fh have been reported since 1968 table 1. Histiocytoma, histiocytoma, benign fibrous, histology introduction dermatofibroma, also known as fibrous histiocytoma, is one of the most common cutaneous softtissue lesions, accounting for approximately 3% of skin lesion specimens received by dermatopathology laboratories. This tumor is usually found in adult extremities but rarely occurs in deep soft tissues of the oral cavity. Pathology outlines benign fibrous histiocytoma superficial. Aneurysmal benign fibrous histiocytoma has a high local recurrence rate, possibly because of incomplete first excision of large lesion. Histiocytic disorders are a group of diseases that occur when there is an overproduction of white blood cells known as histiocytes that can lead to organ damage and tumor formation. We report herein an extremely very rare case of primary benign fibrous histiocytoma of the stomach found in a 56yearold man who presented with a 2week history of nausea and anorexia. The spectrum of fibrohistiocytic tumours with special. Most cases have a favorable prognosis, but certain types have a tendency for recurrence or metastasis in the lungs, lymph nodes, soft tissues or liver. Fibrous histiocytoma is an infrequent type of sarcoma of uncertain basis that appears both in bone and soft tissue. The spectrum of fibrohistiocytic tumours with special emphasis on malignant fibrous histiocytoma j. Media in category benign fibrous histiocytoma this category contains only the following file. Benign fibrous histiocytoma bfh is a benign mesenchymal neoplasm, composed of fibroblasts and histiocytes in variable proportions.
Fibrous histiocytomas are benign fibrohistiocytic bfh tumors. Benign fibrous histiocytoma arising from the right shoulder. These slowgrowing solitary tumors are generally welldefined, painless, and have a rare occurrence. Gastrointestinal xrays and endoscopy revealed a protruding lesion in the stomach, but biopsies failed to demonstrate the nature of the tumor.
Benign fibrous histiocytoma bfh is the most common benign neoplasm in practically all localizations affecting the epidermis. Fibrous histiocytoma, benign tumors, submandibular area, fibrohistiocytic neoplasms. Fibrous histiocytomas are divided into two subgroups. Special emphasis is given to more recently described histological variants of fibrous histiocytoma, e. Benign fibrous histiocytoma of a metacarpal bone bmj case. Benign fibrous histiocytoma fh is a benign tumor composed of fibroblasts and histiocytes in varying proportions. Benign fibrous histiocytoma is a rare tumor of mesenchymal origin.
A dermatofibroma, or benign fibrous histiocytomas, is a benign skin growth dermatofibroma. Brooks introduction debate continues to surround the nature of the controversial set of meenchymal tumours termed fibrohistiocytic and even their nomenclature has been called into question. As it is difficult to diagnose with physical and radiologic exams, deep benign fh can only be diagnosed by histopathology. Its occurrence in the metacarpal bones is even rarer. Received for publication jtuy 3, 1978 fibrous histiocytotna is a generic term wliich defines a distinctive group of tumors having in common both fibrocytic and hisdocydc elements stout. Fibrous histiocytoma of the conjunctiva is rare and can be classified as benign or malignant.
Primary malignant fibrous histioeytoma of skin may have a prognosis superior to homologous tumors arising in deeper soft tissue and the retroperitoneum. Findings of histopathology and immunohistochemistry led to the diagnosis of benign fibrous histiocytoma bfh i. Epithelioid histiocytoma eh, also known as epithelioid cell histiocytoma or epithelioid fibrous histiocytoma, is a rare benign fibrohistiocytic tumor first described in 1989. Know the types, causes, signs, symptoms, treatment, prevention, prognosis, and. To date, approximately 50 oral bfh cases have been reported. Due to its frequency, there is an exhaustive body of literature on benign fibrous histiocytoma of the skin. Epithelioid cell histiocytoma ech, which is also known as epithelioid benign fibrous histiocytoma, is generally considered to be an epithelioid variant of fibrous histiocytoma fh of the skin 1,2,3,4. This group is made up of a wide variety of conditions that can affect both children and adults. Benign fibrous histiocytoma bfh is a rare skeletal tumour. They are composed of two cell types, namely atypical fibroblasts and histiocytes, arranged in a storiform pattern. Pdf variants of dermatofibroma a histopathological study. Benign fibrous histiocytoma dermatofibroma of the face. Therefore, the focus of this paper will be on important variants, other fibrohistiocytic entities in the differential diagnosis and any recent findings, covering only essential information on classical benign fibrous histiocytoma.
It is the most common painful skin tumor, mostly affecting women. Know the types, causes, signs, symptoms, treatment, prevention, prognosis, and complications of fibrous histiocytoma. There is a predilection for dermatofibroma to develop on the extremities, and. Epithelioid cell histiocytoma with sqstm1alk fusion. A clinical and histopathological study of 122 cases of. Apr 10, 2015 epithelioid benign fibrous histiocytoma, also known as epithelioid cell histiocytoma, has traditionally been considered a morphologic variant of cutaneous fibrous histiocytoma dermatofibroma. Dermal and deep fibrous histiocytoma plexiform fibrohistiocytic tumor. Apr 06, 2018 fibrous histiocytoma is an infrequent type of sarcoma of uncertain basis that appears both in bone and soft tissue. Differential diagnosis deep fibrous histiocytoma surgical. Benign fibrous histiocytoma definition of benign fibrous. Dermatofibroma, or benign fibrous histiocytoma, is a common cutaneous nodule that may be superficial or deep. The majority of cases extended into the subcutis and deep soft tissue.
Dermal dendrocytoma, dermatofibroma, fibrous dermatofibroma, fibrous histiocytoma, fibroma simplex, nodular subepidermal fibrosis, and sclerosing hemangioma. Neoplasms originating in the renal capsule are very rare. Dermatofibroma benign fibrous histiocytoma is a common skin lesion and it accounts for approximately 3% of the skin lesion specimens received by one dermatopathology laboratory 1. Epithelioid cell histiocytoma is a well recognised variant of cutaneous fibrous histiocytoma that may be confused with other benign and malignant mesenchymal lesions.
Storiform pattern differs from dermal fibrous histiocytoma. Must have at least areas of histologic features of usual dermal fibrous histiocytoma. A benign tumour composed of primitive mesenchymal cells macrophages or histiocytes seen in the skin and soft tissues of the legs of young to middleaged patients, more commonly women, usually in relation to skeletal muscle. Benign fibrous histiocytoma of subcutaneous tissue, deep soft tissue or parenchymal organs, with no dermal involvement am j surg pathol 1994. A 57 yearold japanese man presented with an asymptomatic. Pdf deep benign fibrous histiocytoma in the oral cavity.
B, up to 80% of angiomatoid fibrous histiocytomas are surrounded by a dense lymphoplasmacytic infiltrate or cuff, which often includes germinal center formation. Is cutaneous benign fibrous histiocytoma dermatofibroma a reactive inflammatory process or a neoplasm. Immunohistochemistry of dermatofibromas and benign fibrous histiocytomas. Ech is a dermalbased benign fibrohistiocytic tumor, which can mimic melanocytic, vascular, epithelial, and other histiocytic lesions. Benign fibrous histiocytoma in a child a case report. Pathology of angiomatoid fibrous histiocytoma dr sampurna. Epithelioid sarcoma resembling benign fibrous histiocytoma. Introduction benign fibrous histiocytoma fh is rare in the head and neck region. There is debate as to whether dermatofibroma has a reactive or neoplastic origin. Benign fibrous histiocytomabfh most commonly occurs in the dermis and subcutis, few cases of this tumor appear in the renal capsule. We report a case of es on the right hand of a 23yearold man that histopathologically resembled a benign fibrous histiocytoma. Epithelioid sarcoma es is a rare malignancy notorious for its tendency to histologically mimic granuloma annulare and other palisading granulomatous processes. No plexiform rays of fibrous tissue extending into fat.
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