Benign fibrous histiocytoma (BHF) of the cheek: CD 68-KP1 positivity

doi:10.1016/S1368-8375(01)00006-9

Oral Oncology

Volume 37, Issue 8, December 2001, Pages 673-675

https://doi.org/10.1016/S1368-8375(01)00006-9 Get rights and content

Abstract

We present a case of fibrous histiocytoma of the cheek in a 32-year-old male with no evidence of any regional invasion or distant metastasis. Pathologic analysis and diagnosis of these lesions is often challenging, and usually based on a combination of light microscopy and immunohistochemistry. In this study the diagnosis was confirmed using immunostaining with the antibody CD 68-KP1 that is positive in any lesion containing lysosomal granules or phagolysosomes.

Introduction

Benign fibrous histiocytoma (BFH) has been described as a benign neoplasm of fibroblasts and histiocytes that affects the soft tissues of the dermis and subcutaneous layers [1]. These neoplasms should be differentiated from the malignant fibrous histiocytoma (MFH), which frequently has an aggressive malignant course [2]. MFH occurs in soft tissues and also bone, usually around the knee, and less frequently in the lower or upper extremities and pelvis [3] and in the face.

BFH was not known as a clinical entity before 1970 when, as a result of the development of immuno-histochemical techniques and electronic microscopy, differential diagnosis became feasible [4]. BFH is seen mainly in adults and most frequently in young and middle aged women. BFH occurs most commonly in the soft tissues in the lower extremities (50%), less frequently in the upper extremities (20%), retroperitoneum (20%) and orbit . Reports of BFH in the facial tissues are rare [5]. We report a rare case of benign fibrous histiocytoma of the cheek in a young patient and show the confirmation of diagnosis by novel immunostaining.

Section snippets

Patients and methods

A 32-year-old male presented in September 1999 with an obvious painless swelling in the right cheek. He had been aware of this for approximately 2 years and it had slowly enlarged. He had no other similar swellings and his medical history was non-contributory. Examination revealed a non-tender elastic-hard lump of approximately 6–7 cm in diameter with a smooth surface, defined periphery and some mobility. The mucosal surface appeared normal. Surgical excision revealed a smooth encapsulated

Discussion

Fibrous histiocytoma exists as a benign or a malignant neoplasm. The terminology used in the literature to identify this group of lesions is unclear, due to difficulties in differential diagnosis between malignant and benign forms. However, the diagnosis of benign histiocytoma should not rely entirely on histological findings, since there are reports of fibrous histiocytomas with benign characteristics that later developed metastases [4], [5].

The most widely used classification for histiocytic

References (22)

H. Kamino et al.
Histopathologic and immunohistochemical diagnosis of benign and malignant fibrous and fibrohistiocytic tumors of the skin
Dermatol Clin
(1999)
S. Hoffman et al.
Fibrous histiocytomas of the oral mucosa
Oral. Surg
(1981)
K.H. Hong et al.
Benign fibrous histiocytoma of the floor of the mouth
Otolaryngol Head Neck Surg
(1999)
S. Bielamowicz et al.
Noncutaneous benign fibrous histiocytoma of the head and neck
Otolaryngol. Head Neck
(1995)
R. Fieldman et al.
Fibrous histiocytomas of the soft palate
Int. J. Pediatr. Otorhinolaryngol
(1989)
A.R. Hudson et al.
Immunohistochemistry in diagnostic dermatopathology
Dermatol Clin
(1999)
J. Asai et al.
Fluorescence automatic cell sorter and immunohistochemical investigation of CD68-positive cells in meningioma
Clin Neurol Neurosurg.
(1999)
T.C. Chen et al.
Dermatofibroma is a clonal proliferative disease
J Cutan Pathol.
(2000)
J. Dahabreh et al.
Inflammatory pseudotumora controversial entity
Eur J Cardiothorac Surg
(1999)
C. Van Laer et al.
Benign fibrous histiocytoma of the larynxpresentation of a case and review of the literature
J Laryngol Otol
(1996)

A. Blitzer et al.

Malignant fibrous histiocytoma of the head and neck

Laryngoscope

(1977)

Cited by (25)

Benign fibrous histiocytoma of the oral and maxillofacial region: A systematic review
2022, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
The aim of the present study was to carry out a systematic review of available data regarding case reports and case series of oral and maxillofacial benign fibrous histiocytoma (BFH).
A search strategy was performed using the PubMed, Web of Science, Scopus, and EMBASE electronic databases.
Male individuals (56.89%) were more affected, with a mean age of 34.55 ± 20 years. The buccal mucosa (20.33%) represented the most common site, with the clinical presentation of a painless (86.95%) nodule (98.03%). The clinical hypothesis of a fibroma was reported in most cases (31.57%). Radiographic presentation of intraosseous lesions showed multilocular radiolucent images (55.55%). Regarding the histopathologic features, the biphasic population of fibroblastic and histiocytic cells was seen in 21 cases (39.62%), and a spindle-shaped fibroblastic cell population organized into a storiform pattern was observed in 25 cases (47.16%). CD68 (n = 26) and vimentin (n = 25) showed immunoreactivity in all BFH cases in which they were used. All cases were treated with a surgical resection, and 8.10% recurred.
The current systematic review demonstrated that BFH represents a rare lesion that mainly affects the buccal mucosa of male individuals, and the treatment is mainly surgical with a good prognosis.
Benign fibrous histiocytoma of larynx
2017, Medical Journal Armed Forces India
Benign fibrous histiocytoma of the ethmoids in an infant
2015, Medical Journal Armed Forces India
Citation Excerpt :
Immunohistochemical staining and ultrastructural examination of the tumors and cell lines derived from them has revealed features of myoblastic and histiocytic differentiation as evidence of mesenchymal origin. Immunostaining for CD68 can be found in any tumor-containing lysosomal granules or phagolysosomes as in our case.4 Factor XIIIα has occasionally been reported for BFH.
Huge deep fibrous histiocytoma arising from the sigmoid mesocolon
2014, Formosan Journal of Surgery
Citation Excerpt :
MDM2/CDK4 is used for liposarcomas. Malignant FH is composed of malignant pleomorphic sarcomatous cells, bizarre giant cells, and frequent mitotic figures.5 The difference between benign and malignant FH is usually obvious, because the latter is a pleomorphic, deep-seated tumor with numerous typical and atypical mitotic figures.6
Benign fibrous histiocytoma is one of the most common mesenchymal neoplasms of the skin, but it rarely occurs in deep soft tissues. Deep fibrous histiocytoma commonly occurs in the lower limbs or the head and neck region. We report an extremely rare case of deep fibrous histiocytoma arising from the sigmoid mesocolon. A 63-year-old woman initially presented with lower abdominal pain. An image study showed a huge heterogeneous pelvic mass with bleeding. The patient was treated successfully by surgery. We review the literature and discuss the clinical presentation, diagnosis, and management of deep fibrous histiocytoma.
Benign fibrous histiocytoma of the cheek
2013, American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Citation Excerpt :
As with benign FH, the diagnosis of malignant FH frequently relies upon immunohistochemistry and electron microscopy to differentiate it from other lesions. Malignant FH is composed of malignant pleomorphic sarcomatous cells, bizarre giant cells, and frequent mitotic figures [9]. The difference between benign and malignant FH is usually obvious, because the latter is a pleomorphic, deeply situated tumor with numerous typical and atypical mitotic figures and prominent areas of hemorrhage and necrosis [10].
Benign fibrous histiocytoma (FH) is a benign neoplasm of a mixture of fibroblastic and histiocytic cells. The tumor occurs most frequently on the skin of the extremities but rarely in deep soft tissues of the head and neck. The diagnosis of benign FH may be clinically difficult, and is frequently confirmed after excision. The most important diagnostic distinction is the separation of this tumor from malignant FH. A 22-year-old male presented with a painless swelling mass on the left cheek. Detailed clinical and laboratory examinations were performed. The patient received angiography with embolization and underwent an intraoral excision of the mass under general anesthesia with primary closure. The histopathology revealed a benign FH. The complete image survey and appropriate treatment of benign FH of the cheek are emphasized.
Transformation of benign fibrous histiocytoma into malignant fibrous histiocytoma in the mandible: Case report
2011, Journal of Oral and Maxillofacial Surgery
Citation Excerpt :
Although the major cause of morbidity in cutaneous BFH is excessive sun exposure, trauma and chronic infection also contribute to the development of BFH.13,22 Similar to cutaneous BFH, trauma and chronic infection contribute to the development of BFH in the bone.13,22 Some researchers have reported MFH arising secondary to trauma and chronic infection.23-27

View all citing articles on Scopus

View full text

Case reportBenign fibrous histiocytoma (BHF) of the cheek: CD 68-KP1 positivity

Abstract

Introduction

Section snippets

Patients and methods

Discussion

Dermatol Clin

Oral. Surg

Otolaryngol Head Neck Surg

Otolaryngol. Head Neck

Int. J. Pediatr. Otorhinolaryngol

Dermatol Clin

Clin Neurol Neurosurg.

Dermatofibroma is a clonal proliferative disease

J Cutan Pathol.

Inflammatory pseudotumora controversial entity

Eur J Cardiothorac Surg

Benign fibrous histiocytoma of the larynxpresentation of a case and review of the literature

J Laryngol Otol

Malignant fibrous histiocytoma of the head and neck

Laryngoscope

Case report
Benign fibrous histiocytoma (BHF) of the cheek: CD 68-KP1 positivity