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Malignant fibrous histiocytoma (inflammatory variant) in a child presenting as paraparesis
Uma N Saikia1, Nalini Gupta, Deepak Bansal
1Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India. umasaikia@yahoo.com
Abstract:
Malignant fibrous histiocytoma (MFH) in the pediatric age group is extremely rare. Inflammatory variant of MFH is still rarer in children, to the extent that only few case reports of inflammatory variant of MFH are available in the English literature. This report is of a case in a 4-year-old male child, who presented with a chest wall swelling. Fine needle aspiration (FNA) smears showed neutrophilic infiltrate was seen in and around the tumor cells showing a prominent neutrophillic phagocytosis. Possibilities of malignant fibrous histiocytoma, malignant rhabdoid tumor and malignant histiocytosis were offered on cytology. Subsequently, an excision biopsy was performed and was diagnosed as inflammatory variant of MFH. Differential diagnosis of this type of tumor with prominent neutrophillic phagocytosis is discussed with importance of immunostaining for diagnosis. Paraparesis as a presenting feature of inflammatory MFH is rare in children and has not been reported in the literature to the best of our knowledge.
Insights
This case report details an extremely rare pediatric inflammatory malignant fibrous histiocytoma (MFH) presenting as a chest wall tumor. The study highlights diagnostic challenges and the rarity of paraparesis as a symptom in pediatric MFH.
Area of Science:
- Pediatric Oncology
- Surgical Pathology
- Cytopathology
Background:
- Malignant fibrous histiocytoma (MFH) is exceptionally rare in children.
- The inflammatory variant of MFH is even rarer, with limited pediatric case reports available.
- This study focuses on a unique pediatric case to contribute to the understanding of this rare entity.
Observation:
- A 4-year-old male presented with a chest wall swelling.
- Fine needle aspiration (FNA) revealed neutrophilic infiltrate and phagocytosis within tumor cells.
- Cytology suggested MFH, malignant rhabdoid tumor, or malignant histiocytosis.
Findings:
- Excision biopsy confirmed the diagnosis of inflammatory variant of MFH.
- The presence of prominent neutrophilic phagocytosis posed diagnostic challenges.
- Immunohistochemistry is crucial for differentiating this tumor type.
Implications:
- This case underscores the rarity of inflammatory MFH in pediatric patients.
- It highlights the diagnostic utility of FNA and subsequent biopsy in pediatric chest wall masses.
- The report emphasizes the importance of considering rare differentials and utilizing immunostaining for accurate diagnosis.
