A case of atypical benign fibrous histiocytoma

A case of atypical benign fibrous histiocytoma is reported. A 62-year-old Japanese female visited our clinic because of an asymptomatic solitary lesion on the skin of the left leg. Physical examination revealed a polypoid mass lesion (2.5 x 2.3 x 1.8 cm) with central erosion. The lesion began with a 1 mm-sized papule and slowly enlarged over the 20 years. Clinical diagnosis was a malignant tumor such as dermatofibrosarcoma protuberans, atypical fibroxanthoma or adnexal tumors. Biopsy of the polypoid lesion was carried out. Histopathological examination revealed a polypoid lesion consisting of proliferation of fibroblast-like spindle cells in the dermis. Large atypical cells with pleomorphic nuclei were occasionally observed but mitotic figures were rare. From immunohistochemical results (CD68, Factor-XIII, MIB-1 labeling index), we diagnosed this case as "atypical benign fibrous histiocytoma (ABFH)". Clear distinction has not been made between ABFH, a variant of benign fibrous histiocytoma, and atypical fibroxanthoma, which is a variant of malignant fibrous histiocytoma. Here we report a case of ABFH with a diagnosis of the neoplasm.