Malignant fibrous histiocytoma: histomorphological pattern or tumor type

Abstract

During the past years MFH has obviously been used as a diagnostic waste basket for hard to classify tumours of all kinds. Immunohistochemistry revealed insights into cellular differentiation of neoplastic proliferations, also raising new questions because of unexpected antigen expression, as, for instance, cytokeratins in MFH. Thus, a number of tumours originally diagnosed as MFH could be reclassified, i.e., as leiomyosarcoma, melanoma or anaplastic carcinoma. Nevertheless, there remain a certain number of sarcomas which lack any evidence of special cellular differentiation. These proliferations of primitive mesenchymal or fibroblastic cells, often with a typical histological, storiform pattern, qualify as MFH. Using these strict criteria, the diagnosis of MFH will become rarer, though not obsolete (like hemaugioperizytoma years ago!).