Benign Fibrous Histiocytoma
Benign fibrous histiocytoma is a cutaneous tumor with predominantly dermal involvement, mainly composed of cells with fibro-histiocytic differentiation.
It may occur at any age, but it is most common in adults.
The treatment of choice is surgical excision.
Complete surgical excision is usually curative.
BFH appears as a firm, non-encapsulated lesion of the dermis, with white to yellow cut surface. Cystic changes and hemorrhage may be present.
BFH is positive for vimentin, CD68, and factor XIIIa. A minor population of actin-positive myofibroblasts may be present. CD34 is negative.
The main differential diagnosis is with dermatofibrosarcoma protuberans. This shows extension in the subcutaneous fat with entrapment of single adipocytes, consists of a monomorphous population of spindle cells, and is positive for CD34. The atypical variant of BFH should not be confused with a pleomorphic sarcoma. Atypical mitoses and necrosis are absent in BFH.