Malignant fibrous histiocytoma of the maxilla

Malignant fibrous histiocytoma of the maxilla Report

of a case

ie

siw ad ncoplasticnature of theselesions.Theseauthors pr’nposedthe tern i~iffariwrtrfort~

Kyriakos lllaJltli~Jl
BOJle

tissue,

aJld

TVCJS

hisfiocyfo~tict

l’cq~)t’tc~t

:I

Soft

tiSSWS

Ilot rel)ortetl.

1lklS IJWJI

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to tlc5ignaIc this ltsioix. One: of thci wscs cliscussctl tlicl WY~UI in the fioor of thr n
Jihmus

and KcmI)son

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cilsc

in

mantliblc. ~:?iligii

fibrous

S~‘h~‘ilJ~(J~dl’

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histioc-tolila Albright

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fil)rous

J)riJllCJl,‘v

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iLlld

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ant1

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was

lovalizeti

iJi

in the’ oral :Jlltl

lOCdiZdiOl1,

histioqtome

ra\,it?-

SOkIJnOlL the

bOJJC 01‘

occurring soft

and tissues

was rcportec~

the!

ill

Button Of

by I
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DISCUSSION \\‘hrn data

in

the clinical the

pretatioJL

and histopathologic \-arious similar

lit,erature, of

the

IesioJJ

as

an

tlata aspwts

eosino~~hilic

our patient arc compared with present. The initial misintf>rgranuloma or benign inflammatory (Jf

arc

reaction ~~1s also rcportctl in association with inflammatory fibrous histioq-toma. interThr~ tumor in the case reportetl 1)~ Spector and Ogura In was also initially prctcstf as chronic inflammation alid, aftci* another biopsy, as fibrosarroma. The tliagnosis of (fibro)sarcwma was als~~ made in one fourth of the patients revortccl l)y

Sl’aJlier

and

her

co-workers.

i The>-

did

report

the

occurrence

of

lymph

~OC~I~

value. The I,LYWJJC of metastasis c~rit~~rioll (~1 great in our paticlrt, had bwn the motive for further study and discussion, bringin$ about thtx final diagnosis. The eosinophilia of the blood, disappearing after cstil-remains curious. Kyriakos and k’empsoll” KY~J~J~K~ nClltr(lpatic]JL of the tumor, philic~ Iwkocytosis, but in our wsc there was 110 lcukocytosis. The white bloclcl coullt was not elevated ; the incrcaw ill the numbc,r of eosinophils came at. t,ll(\ mc+astnsis

cS~‘N’llSC

as

Of

the’

a diagIl~JStk

llcUtru[JhilS.

IJJ

OJJC

of

the

CYJSc!S

lY?pOrtd

by

SpallkJ

alid

associ-

ates.: mcwtion was ma&l of an eosillophilir infiltrate in the tnmor ; cosinophilia of tllcx 1)lootl was not reported. ‘I’hc histopalhologic features of the tumor aqce very well with that clwrilw~l by Kcmpson anti Kyriakos,’ ni~nlrl~, l,ixn.rre poly~~orphic~ fil)roblasts in a fibrous pilttc~rll, histioq-tcs and histioyytic giant, cells, a.ntl an occasional foam cell. Thtl storiform pattci*~i was not very conspicuous, being present in only a few lym~~ll noclcs. An inflammatory infiltrate, as reported by Spnnier antI collcagnes,’ wls SC(VI throughout the entire tumor-. The I)irnudal differentiation of the tumor ~11s as histiocyte a~Jd fibroblast dots espi~w itself in the tumor of our palient in the formation of giant. and foam ~11s ant1 iJL the production of fibers and grourd substance. The theoretical implib?; E’u ant[ his cations of the relation l~<~l\vee~~both cell tyfws \vet’c :lJl?il)-~~l Cv,llwgLlt’s.‘~ They found. in ultrastructural investigations, both histiocptic> alid fil~roblastic~ cells as well as an nndiff(~rclltiatc~ti small cell. TToxcwr, t.hey wwe not ;~ble to shoxv cells n-it11 morpl~ologic ~:haractoristics of l)oth ccl1 types. Thus, th(‘y consitlerctl the c~~iicept 01 the 1Jimdal &ffcrcJltiatioll a matter of i’urthcr invcstigation. Honewr, in the fibrous histiocvtonias, benign as well as malignant~, two clearly scparatcd cell populations do csist with aspwts of either fibroblasts or histicwytes. Thus, the co~~cept has its value iJl ticfining a group of lesions.