Skin nonmelanocytic tumor

Fibrous, fibrohistiocytic and myofibroblastic neoplasms

Dermatofibroma (cutaneous fibrous histiocytoma)-aneursymal

Topic Completed: 1 August 2019

Minor changes: 9 December 2020

Copyright: 2002-2021,, Inc.

PubMed Search: Aneurysmal fibrous histiocytoma

Vijay Shankar, M.D.
Page views in 2020: 3,086
Page views in 2021 to date: 4,299
Cite this page: Shankar V. Dermatofibroma (cutaneous fibrous histiocytoma)-aneursymal. website. Accessed December 3rd, 2021.
Definition / general
  • Rare variant with dermal spindle cells and lakes of blood, but no endothelium
  • 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
  • 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:

Cysts lacking an endothelial lining

Larger cysts bordered by a squamous lining

Squamous lining lacked a granular layer

cellular proliferation
containing numerous
blood filled cysts

Various images

Large irregularly shaped cysts resembling HPC

Large irregularly shaped cysts resembling HPC

Hemangiopericytoma-like pattern of cysts

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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