title: Atypical fibrous histiocytoma of the skin and subcutis in childhood and adolescence.
abstract: The authors have observed 15 examples of a distinctive fibrohistiocytic lesion in children and adolescents which they chose to designate as "atypical fibrous histiocytoma" (AFH). Patient ages ranged from 1 to 19 years (mean 9.3 yr.). Only two cases were encountered in the first year of life, but 7 were seen in children under the age of 10 yr. The anatomic distribution of AFH showed a tendency for a truncal origin (66%), and none was located in the skin of the face, neck, or scalp. Tumor sizes ranged from 1 to 3 cm, and one-third were 2 cm or greater in maximum dimension. Histologically, AFH was characterized by a multinodular, dermal or dermal-subcuticular proliferation of spindle cells, with tapered, cytologically bland nuclei. However, nucleocytoplasmic ratios were increased when compared with those of normal fibroblasts. Nuclear chromatin was dispersed or vesicular; nucleoli were seen in a minority of cases, but mitotic activity was regularly present. Admixed giant cells were present but infrequent, cellularity was dense, and a storiform growth pattern was consistently seen. Mean followup in this group of cases averaged 75 mo. Seven patients (47%) had tumor recurrences after initial excision; in two of these, tissue margins had been free of involvement. The authors conclude that AFH of childhood is analogous to a lesion that has previously been reported as "benign fibrous histiocytoma" in adults. Complete excision and regular postoperative surveillance are recommended for these tumors.
authors.affiliation: Division of Surgical Pathology, Barnes Hospital, Washington University Medical Center, St. Louis, MO 63110.
authors.forename: A J
authors.initials: AJ
authors.lastname: Marrogi
authors.forename: L P
authors.initials: LP
authors.lastname: Dehner
authors.forename: C M
authors.initials: CM
authors.lastname: Coffin
authors.forename: M R
authors.initials: MR
authors.lastname: Wick
mesh_terms: D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D002401:Cathepsin B / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D018219:Histiocytoma, Benign Fibrous / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D007223:Infant; D008297:Male; D012867:Skin / Q000737:chemistry / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D014746:Vimentin / Q000032:analysis; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D002401:Cathepsin B; D014746:Vimentin; C067980:CD68 antigen, human; D000097382:CD68 Molecule