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RESIDENT
CASE
STUDIES
October 23,
2003: Case 1 Table
of Contents | List
of Diagnoses | Case 1 | Case 2
48 year old female with punch biopsy.
Clinical history not provided.
Discussion by Dan Klink, MD
Malignant fibrous histiocytoma if the most
common soft tissue malignancy in adults.
Distribution: 50-70 year olds
Gross Appearance: Fleshy
multilobulated tan-gray mass
Microscopic
Appearance:
- Storiform pattern with large pleomorphic
cells with prominent nucleoli
- Frequent mitotic figures are present
- Subtypes include myxoid, angiomatoid,
inflammatory, pleomorphic, and giant cell.
Diagnostic Criteria
- Storiform pattern
- Large pleomorphic cells
- Other types of sarcoma excluded
Immunostains:
- Vimentin
- CD 68
- Factor XIII positive
Differential Diagnosis:
- Pleomorphic liposarcoma
- Pleomorphic rhabdomyosarcoma
- Dermatofibrosarcoma protuberans
- Myxoid liposarcoma
References:
- Enzinger FM, Weiss SW, and Goldblum, JR. Weiss's Soft Tissue Tumors. St Louis: Mosby Publishing; 1995.
- Haber M. et al, Differential diagnosis in surgical pathology, Copyright 2002.
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