Skin nonmelanocytic tumor
Fibrous, fibrohistiocytic and myofibroblastic neoplasms
Fibrous histiocytoma-aneursymal


Topic Completed: 1 August 2019

Minor changes: 1 October 2020

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PubMed Search: Aneurysmal fibrous histiocytoma

Vijay Shankar, M.D.
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Cite this page: Shankar V. Fibrous histiocytoma-aneursymal. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/softtissuefhaneurysmal.html. Accessed October 21st, 2020.
Definition / general
  • Rare variant with dermal spindle cells and lakes of blood, but no endothelium
Terminology
  • First described in 1981 (Cancer 1981;47:2053)
  • Early lesion also called hemosiderin variant of fibrous histiocytoma
  • Similar to sclerosing hemangioma variant of fibrous histiocytoma, which has more prominent capillaries, but differs from lung lesion called sclerosing hemangioma
Clinical features
Case reports
Treatment
  • Excision
  • Tends to recur if there is incomplete excision
  • Rarely metastasizes
Clinical images

Images hosted on other servers:
Exophytic lesion with<br>slight scaling; irregular<br>coloration mimics melanoma

Exophytic lesion with
slight scaling; irregular
coloration mimics melanoma

Grayish brown atrophic shiny patch

Grayish brown atrophic shiny patch

Gross description
  • Blue, black or dark red cystic nodule
  • Size varies from 0.5 to 4 cm
  • Rarely presents as atrophic patch
Microscopic (histologic) description
  • Storiform pattern of fibrohistiocytic cells (as in classic fibrous histiocytoma), but many cells are filled with hemosiderin
  • Also large cystic spaces filled with blood, but without an endothelial lining
  • Bizarre cells often present
  • May have hemangiopericytoma-like pattern of cysts
  • Periphery may have hyalinized collagen bundles surrounded by tumor cells (Histopathology 1995;26:323)
  • Usually epidermal hyperplasia
  • May have up to 10 MF / 10 HPF

  • Dermoscopy description: Multicomponent pattern with central blue / red homogeneous area, white structures, peripheral delicate pigment network and vascular structures (Br J Dermatol 2006;154:244); this pattern also present in some melanomas
Microscopic (histologic) images

AFIP images
Nonendothelial lined clefts or lakes containing blood Nonendothelial lined clefts or lakes containing blood

Nonendothelial lined clefts or lakes containing blood

Large amounts of hemosiderin

Large amounts of hemosiderin

Hemosiderin with marked sclerosis

Hemosiderin with marked sclerosis



Images hosted on other servers:

Various images


Large irregularly shaped cysts resembling HPC

Large irregularly shaped cysts resembling HPC

Hemangiopericytoma-like pattern of cysts

Hemangiopericytoma-like pattern of cysts

Positive stains
Negative stains
Electron microscopy description
  • Hemosiderin containing histiocyte-like cells, fibroblast-like cells and intermediate cells
  • No prominent proliferation of endothelial cells (Am J Dermatopathol 1995;17:179)
Molecular / cytogenetics description
Differential diagnosis
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