Angiomatoid fibrous histiocytoma: Clinicopathological and molecular characterisation with emphasis on variant histomorphology

Yu-Chien Kao, Jui Lan, Hui Chun Tai, Chien Feng Li, Kai Wen Liu, Jen Wei Tsai, Fu Min Fang, Shih Chen Yu, Hsuan Ying Huang

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Aims Angiomatoid fibrous histiocytoma (AFH) is histologically typified by nodules of histiocytoid spindle cells with pseudoangiomatoid spaces, fibrous pseudocapsules and lymphocytic cuffs. The principal goal was to expand the spectrum of AFHs through clinicopathological and molecular characterisation. Methods Thirteen AFHs, including 11 with confirmed hallmark translocation, were reappraised for classic features, reactive osteoclasts, mitoses and stromal, architectural and cytomorphological variations, with CD99, desmin and EMA stained in available cases. Results Seven male and six female patients ranged in age from 4 to 63 years (median, 13), including 4 older than 20 years. Tumours were located on the extremities (n=6), trunk (n=4) and scalp (n=3). Although fibrous pseudocapsules were observed in all cases, four showed solid histology without pseudoangiomatoid spaces and another one lacked peripheral lymphoid infiltrates. Nuclear pleomorphism was striking in two cases, moderate in seven and absent in four, with osteoclasts seen in two cases. In three AFHs with sclerotic matrix, one exhibited perivascular hyalinisation and nuclear palisading, reminiscent of a schwannoma. In three varyingly myxoid tumours, one closely resembled a myoepithelioma with prominent reticular arrangement of spindle cells in an abundant myxoid stroma. Besides EWSR1 gene rearrangement detected in four cases by fluorescence in situ hybridisation (FISH), EWSR1-CREB1 fusion was confirmed in nine cases, including a schwannoma-like AFH, and EWSR1-ATF1 fusion detected in a myoepithelioma-like AFH. Immunohistochemically, 56% of AFHs were positive for EMA, 78% for desmin and 100% for CD99. Conclusions Molecular testing is diagnostic of variant AFHs displaying diverse histomorphological alterations in the architectural patterns, cytomorphology and extracellular matrix.

Original languageEnglish
Pages (from-to)210-215
Number of pages6
JournalJournal of Clinical Pathology
Volume67
Issue number3
DOIs
Publication statusPublished - Mar 1 2014

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Myoepithelioma
Desmin
Neurilemmoma
Osteoclasts
Molecular Diagnostic Techniques
Gene Rearrangement
Scalp
Fluorescence In Situ Hybridization
Mitosis
Extracellular Matrix
Neoplasms
Histology
Extremities
Angiomatoid Fibrous Histiocytoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Angiomatoid fibrous histiocytoma : Clinicopathological and molecular characterisation with emphasis on variant histomorphology. / Kao, Yu-Chien; Lan, Jui; Tai, Hui Chun; Li, Chien Feng; Liu, Kai Wen; Tsai, Jen Wei; Fang, Fu Min; Yu, Shih Chen; Huang, Hsuan Ying.

In: Journal of Clinical Pathology, Vol. 67, No. 3, 01.03.2014, p. 210-215.

Research output: Contribution to journalArticle

Kao, Yu-Chien ; Lan, Jui ; Tai, Hui Chun ; Li, Chien Feng ; Liu, Kai Wen ; Tsai, Jen Wei ; Fang, Fu Min ; Yu, Shih Chen ; Huang, Hsuan Ying. / Angiomatoid fibrous histiocytoma : Clinicopathological and molecular characterisation with emphasis on variant histomorphology. In: Journal of Clinical Pathology. 2014 ; Vol. 67, No. 3. pp. 210-215.
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T2 - Clinicopathological and molecular characterisation with emphasis on variant histomorphology

AU - Kao, Yu-Chien

AU - Lan, Jui

AU - Tai, Hui Chun

AU - Li, Chien Feng

AU - Liu, Kai Wen

AU - Tsai, Jen Wei

AU - Fang, Fu Min

AU - Yu, Shih Chen

AU - Huang, Hsuan Ying

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N2 - Aims Angiomatoid fibrous histiocytoma (AFH) is histologically typified by nodules of histiocytoid spindle cells with pseudoangiomatoid spaces, fibrous pseudocapsules and lymphocytic cuffs. The principal goal was to expand the spectrum of AFHs through clinicopathological and molecular characterisation. Methods Thirteen AFHs, including 11 with confirmed hallmark translocation, were reappraised for classic features, reactive osteoclasts, mitoses and stromal, architectural and cytomorphological variations, with CD99, desmin and EMA stained in available cases. Results Seven male and six female patients ranged in age from 4 to 63 years (median, 13), including 4 older than 20 years. Tumours were located on the extremities (n=6), trunk (n=4) and scalp (n=3). Although fibrous pseudocapsules were observed in all cases, four showed solid histology without pseudoangiomatoid spaces and another one lacked peripheral lymphoid infiltrates. Nuclear pleomorphism was striking in two cases, moderate in seven and absent in four, with osteoclasts seen in two cases. In three AFHs with sclerotic matrix, one exhibited perivascular hyalinisation and nuclear palisading, reminiscent of a schwannoma. In three varyingly myxoid tumours, one closely resembled a myoepithelioma with prominent reticular arrangement of spindle cells in an abundant myxoid stroma. Besides EWSR1 gene rearrangement detected in four cases by fluorescence in situ hybridisation (FISH), EWSR1-CREB1 fusion was confirmed in nine cases, including a schwannoma-like AFH, and EWSR1-ATF1 fusion detected in a myoepithelioma-like AFH. Immunohistochemically, 56% of AFHs were positive for EMA, 78% for desmin and 100% for CD99. Conclusions Molecular testing is diagnostic of variant AFHs displaying diverse histomorphological alterations in the architectural patterns, cytomorphology and extracellular matrix.

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