Soft tissue
So called fibrohistiocytic
Benign
Deep benign fibrous histiocytoma


Topic Completed: 1 August 2012

Minor changes: 25 September 2020

Copyright: 2002-2020, PathologyOutlines.com, Inc.

PubMed Search: Deep benign fibrous histiocytoma

Christopher S. Hale, M.D.
Vijay Shankar, M.D.
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Cite this page: Hale CS, Shankar V. Deep benign fibrous histiocytoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/skintumornonmelanocyticdeepbfh.html. Accessed October 28th, 2020.
Definition / general
  • Benign fibrous histiocytoma of subcutaneous tissue, deep soft tissue or parenchymal organs, with no dermal involvement (Am J Surg Pathol 1994;18:677, Am J Surg Pathol 1990;14:801, Stanford Medicine)
  • Rare painless lesions, < 1% of fibrohistiocytic tumors
  • Usually adult males > 25 years (range 6 - 84 years)
  • Usually extremities, head and neck, trunk; rarely in deep soft tissue of retroperitoneum, mediastinum or pelvis
Case reports
Treatment
Clinical images

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Nodule in arch of foot

Gross description
  • Well circumscribed with pseudocapsule, typically 4 cm (range 0.5 to 25 cm), variable hemorrhage
Microscopic (histologic) description
  • Prominent storiform pattern of uniform spindle cells with ill defined eosinophilic cytoplasm and bland, elongated or plump vesicular nuclei with no atypia
  • Often hemangiopericytoma-like vasculature
  • Scattered lymphocytes, either multinucleated giant cells, osteoclastic giant cells or foam cells in 59%
  • Usually less than 5 mitotic figures / 10 HPF
  • Stroma is myxoid or hyaline
  • Borders are non-infiltrative, with no trapping of fat cells
  • Necrosis or angiolymphatic invasion are rare
Microscopic (histologic) images

AFIP images

Circumscribed tumor with no trapped fat

Cellular tumor

Tumor with more fibrous stroma

Foam cells help distinguish from DFSP



Focal storiform pattern and cellular uniformity

Hemangiopericytoma-like vascular pattern



Case #360



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Various images

Positive stains
Negative stains
Differential diagnosis
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