Malignant fibrous histiocytoma and fibrosarcoma of bone: a re-assessment in the light of currently employed morphological, immunohistochemical and molecular approaches.

Malignant fibrous histiocytoma (MFH) and fibrosarcoma (FS) of bone are rare malignant tumours and contentious entities. Sixty seven cases labelled as bone MFH (57) and bone FS (10) were retrieved from five bone tumour referral centres and reviewed to determine whether recent advances allowed for rec...

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Published in:Virchows Archiv: European Journal of Pathology Vol. 461; no. 5; pp. 561 - 571
Main Authors: Romeo S, Bovée JV, Kroon HM, Tirabosco R, Natali C, Zanatta L, Sciot R, Mertens F, Athanasou N, Alberghini M, Szuhai K, Hogendoorn PC, Dei Tos AP, Romeo, Salvatore, Bovée, Judith V M G, Kroon, Herman M, Tirabosco, Roberto, Natali, Cristina, Zanatta, Lucia, Sciot, Raf
Format: research Journal Article
Published: Springer Nature Nov2012
Online Access:View this record in EBSCOhost
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      dt: Nov2012
      vid: 461
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      pub: Springer Nature
      place: New York, New York
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        atl: Malignant fibrous histiocytoma and fibrosarcoma of bone: a re-assessment in the light of currently employed morphological, immunohistochemical and molecular approaches.
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        au:
          Romeo S
          Bovée JV
          Kroon HM
          Tirabosco R
          Natali C
          Zanatta L
          Sciot R
          Mertens F
          Athanasou N
          Alberghini M
          Szuhai K
          Hogendoorn PC
          Dei Tos AP
          Romeo, Salvatore
          Bovée, Judith V M G
          Kroon, Herman M
          Tirabosco, Roberto
          Natali, Cristina
          Zanatta, Lucia
          Sciot, Raf
        affil: Department of Pathology, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
      sug:
        subj:
          Bone Neoplasms Diagnosis
          Neoplasms, Fibrous Tissue Diagnosis
          Adult
          Aged
          Aged, 80 and Over
          Bone Neoplasms
          Bone Neoplasms Metabolism
          Bone Neoplasms Mortality
          DNA Analysis
          Diagnosis, Differential
          Diagnostic Errors
          Europe
          Female
          Neoplasms, Fibrous Tissue
          Neoplasms, Fibrous Tissue Metabolism
          Neoplasms, Fibrous Tissue Mortality
          Prospective Studies
          Human
          In Situ Hybridization, Fluorescence
          Leiomyosarcoma Diagnosis
          Male
          Middle Age
          Osteosarcoma Diagnosis
          Rhabdomyosarcoma Diagnosis
          Tumor Markers, Biological Metabolism
          Young Adult
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Malignant fibrous histiocytoma (MFH) and fibrosarcoma (FS) of bone are rare malignant tumours and contentious entities. Sixty seven cases labelled as bone MFH (57) and bone FS (10) were retrieved from five bone tumour referral centres and reviewed to determine whether recent advances allowed for reclassification and identification of histological subgroups with distinct clinical behaviour. A panel of immunostains was applied: smooth muscle actin, desmin, h-caldesmon, cytokeratin AE1-AE3, CD31, CD34, CD68, CD163, CD45, S100 and epithelial membrane antigen. Additional fluorescence in situ hybridisation and immunohistochemistry were performed whenever appropriate. All cases were reviewed by six bone and soft tissue pathologists and a consensus was reached. Follow-up for 43 patients (median 42 months, range 6-223 months) was available. Initial histological diagnosis was reformulated in 18 cases (26.8 %). Seven cases were reclassified as leiomyosarcoma, six as osteosarcoma, three as myxofibrosarcoma and one each as embryonal rhabdomyosarcoma and interdigitating dendritic cell sarcoma. One case showed a peculiar biphasic phenotype with epithelioid nests and myofibroblastic spindle cells. Among the remaining 48 cases, which met the WHO criteria for bone FS and bone MFH, we identified five subgroups. Seven cases were reclassified as undifferentiated pleomorphic sarcoma (UPS) and 11 as UPS with incomplete myogenic differentiation due to positivity for at least one myogenic marker. Six were reclassified as spindle cell sarcoma not otherwise specified. Among the remaining 24 cases, we identified a further two recurrent morphologic patterns: eight cases demonstrated a myoepithelioma-like phenotype and 16 cases a myofibroblastic phenotype. One of the myoepithelioma-like cases harboured a EWSR1-NFATC2 fusion. It appears that bone MFH and bone FS represent at best exclusion diagnoses.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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