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High power of a malignant fibrous histiocytoma
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High power of a malignant fibrous histiocytoma

A high power view of a malignant fibrous histiocytoma.
Typical features are highlighted in this image.
The two black arrows point to multi-nucleated giant cells typical of this lesion.
The one just above the center appears to have a large number of nuclei arranged in a horse-shoe shaped structure within the cell.
The two green arrows point to extremely hyperchromatic nuclei that seem almost black in this image.
This degree of hyperchromasia and bizzare giant cells are typical of malignant fibrous histiocytoma.
(Description By:T.V.Rajan, M.D. )
(Image Contrib. by:T.V.Rajan, M.D. UCHC )
Malignant Fibrous Histiocytoma
Etiology

Unknown
Pathogenesis

Unknown,
Epidemiology

Occur somewhat more frequently in men.
General Gross Description

Grossly, they are large tan masses that are frequently associated with hemorrhage.
They arise in the soft tissue of the body, and can erode into bone and soft tissues.
General Microscopic Description

Histologically, malignant fibrous histiocytoma (MFH) consists of spindly fibroblasts with large numbers of bizarre, multi-nucleated giant cells.
There is a tendency of some of the mononuclear cells to resemble histiocytes.
The cells are typically arranged in a "storiform" or "carriage wheel" pattern radiating out like curved spokes from a central point.
Mitoses are numerous which along with cellular pleomorphism and necrosis are indicative of the neoplasms high grade.
Clinical Correlation

These are usually present as enlarging, painful masses that often cause pathological fractures, due to destruction of bone by the neoplasm..
The prognosis is poor with a 20% survival at five years.
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 1243.
Malignant Fibrous Histiocytoma
Synopsis by: T.V. Rajan M.D. Ph.D. (T1X000M88303)[87]
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