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


Topic Completed: 1 August 2012

Minor changes: 18 September 2020

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

PubMed Search: Angiomatoid fibrous histiocytoma [title]

Vijay Shankar, M.D.
Page views in 2019: 6,884
Page views in 2020 to date: 5,693
Cite this page: Shankar V. Fibrous histiocytoma-angiomatoid. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/softtissuefhangiomatoid.html. Accessed October 21st, 2020.
Definition / general
  • Uncommon variant with thick pseudocapsule, marked chronic inflammatory infiltrate and cystic areas of hemorrhage
  • Also called fibrohistiocytic tumor of intermediate malignancy
Terminology
  • First described in 1979 (Cancer 1979;44:2147)
  • Formerly called angiomatoid malignant fibrous histiocytoma
  • May not actually be fibrohistiocytic - Rosai believes origin is vessel related myoid cells with inflammatory features
Clinical features
  • Teens / young adults, often on extremities in areas of lymphoid tissue (popliteal fossa, decubital fossa) or neck
  • Rare in elderly
  • Often fever, malaise, anorexia, anemia, paraproteinemia
  • Unusual sites: lung, mediastinum, ovary, retroperitoneum, vulva (Mod Pathol 2011;24:1560)
Case reports
Treatment
  • Excision; may recur locally (10%), distant metastases are rare (1%, Hum Pathol 1999;30:1336)
  • Radiotherapy if wide excision margins are not feasible
Clinical images

Images hosted on other servers:

Axillary mass at surgery

Gross description
  • Circumscribed, multinodular or multicystic hemorrhagic mass
  • Median 2 cm, usually subcutaneous
Microscopic (histologic) description
  • Thick fibrous pseudocapsule surrounds nodules, sheets, short fascicles or whorls of monomorphic bland spindle to ovoid eosinophilic cells
  • Often highly cellular with bland histiocytoid cells and hemorrhagic cyst-like spaces, large aggregates of chronic inflammatory cells at edge of tumor in lymphoid follicles
  • May have moderate pleomorphism and mitotic activity
  • Rare clear cells, rhabdomyoblast-like cells, myxoid change in stroma (Mod Pathol 2011;24:1560)
Microscopic (histologic) images

Images hosted on PathOut server:

Resembles out of place lymph node

Chronic inflammatory cells and nodules of cells with round / oval nuclei surround hemorrhagic cystic spaces

Cells surrounding
cystic spaces are
uniform with
round / oval nuclei

Some tumors have moderate pleomorphism



Contributed by Mark R. Wick, M.D.

Perls iron

Various images



Images hosted on other servers:

Morphologic features

H&E and desmin

Cytology description
  • Histiocyte-like cells in clusters or dispersed
  • Eosinophilic mesenchymal fragments in bloody background with lymphocytes
  • Tumor cells have moderate pleomorphism with abundant fragile cytoplasm and prominent nucleoli (Diagn Cytopathol 2005;33:116)
Positive stains
Negative stains
Molecular / cytogenetics description
Molecular / cytogenetics images

Images hosted on other servers:

FISH

Differential diagnosis
Back to top
Image 01 Image 02