Primary pulmonary malignant fibrous histiocytoma

Abstract

Malignant fibrous histiocytoma (MFH) is one of the most common adult soft tissue sarcomas. MFH is very aggressive and is most often found in the extremities and the retroperitoneum, but it can manifest at other sites. Though the lungs are the most common sites of metastasis, they rarely present there as a primary tumor. Our report describes a rare case of a primary MFH tumor in the lung. Careful diagnostic procedure should be followed to ensure the tumor does not have extrapulmonary origins. Though MFH is highly invasive and deadly, surgical excision of the tumor has been shown to be successful.

Figure 1

(a) Large right pleural mass indicated by the arrow. (b) Intense PET dye reaction indicates presence of metabolically active mass; uptake in the core of the lesion is reduced, reflecting tissue necrosis, verified upon surgical resection.

Figure 2

Hematoxylin and eosin stained section at 400x magnification demonstrating highly pleomorphic cells with prominent nucleoli in a storiform pattern. Multinucleated forms are also present.

Figure 3

High power H & E stain photomicrograph demonstrating pleomorphic giant cells, spindle shaped fibroblasts, and histiocytes.