Fibrous histiocytoma of the lung.

Abstract

(1976). Thorax, 31,[475][476][477][478][479]. Fibrous histiocytoma of the lung. A case of asymptomatic fibrous histiocytoma of the lung is described in a 14-year-old girl. A left thoracotomy was performed followed by partial resection of the lingula. Postoperative progress was uneventful.When a 'coin' lesion is found on radiological examination of the chest one of the differential diagnoses to be considered is fibrous histiocytoma of the lung. This lesion is difficult to classify as. its origin is not firmly established. Many authors consider it to be a variant of sclerosing haemangioma although there are no morphological criteria for such a view. The purpose of this report is to describe a case of asymptomatic fibrous histiocytoma of the lung occurring in a 14-yearold girl. CASE REPORTA 14-year-old white girl was referred to 'La Paz' Hospital for surgical evaluation of a pulmonary opacity found on routine x-ray examination of the chest. One year before admission she had complained of a mild pain in the posterior part of the left hemithorax. One month before admission she had an episode of high fever. Physical examination revealed no abnormality. Her erythrocyte sedimentation rate was 95 mm in the first hour but apart from this there was no haematological or biochemical abnormality. The sputum did not contain acid-fast bacilli and no tumour cells were seen. A tuberculin test was negative. Respiratory function tests were normal. The chest radiograph showed a well-circumscribed nodule 5 cm in diameter present in the left upper lobe (Fig. 1). A left thoracotomy was performed and a nodule was found to be present in the lingula. Partial resection of the lingula was performed. Postoperative recovery was uneventful and one year after the operation no clinical or radiological abnormality of the chest was present.PATHOLOGY The gross appearance of the tumour showed a clearly demarcated, encapsulated nodule measuring 6X5X5 cm. It was soft and the cut surface had a white fasciculated appearance punctuated by isolated yellowish areas. Histology Sections showed the tumour to be composed of numerous spindle-shaped cells with elongated vesicular nuclei and prominent nucleoli. The cells were arranged in compact bundles with a little surrounding collagen (Figs 2 and 3). Interspersed throughout the lesion were small isolated groups of polygonal-shaped cells with plentiful cytoplasm and indented nuclei that were considered to be histiocytes. These cells were often surrounded by fairly numerous plasma cells and lymphocytes (Fig. 4).The Prussian blue reaction revealed isolated granules of haemosiderin in some of the histiocytic zones. In other areas the histiocytes contained a considerable quantity of lipid in their cytoplasm (Fig. 5) and this was confirmed by fat stains on frozen sections.Blood vessels were not a prominent feature of the tumour. Mitoses were very scanty and there was no significant cellular atypia. Reticulin was scanty and revealed no distinct pattern; in particular there was no evidence of its exhibiting a periva...

‘Benign’ fibrous histiocytoma of the trachea

“…In spite of their histologically benign features recurrences after local resection are frequent and maintain the same microscopic characteristics. This is in contrast to the fibro-histiocytic neoplasms seen at other levels of the respiratory tract, particularly those localised in the larynx (Canalis et al, 1975;Ferlito, 1978;Johnson and Poushter, 1977;Rolander et al, 1972), and in the lung (Kern et al, 1979;Viguera et al, 1976), in which the histologically malignant form is common and distant metastases are frequent.…”

Primary Pulmonary Malignant Fibrous Histiocytoma

“…The most common histologic subtype noted in primary pulmonary MFH is storiform-pleomorphic [ 6 ]. The marked cellular pleomorphism and atypia along with numerous mitotic figures found in primary pulmonary MFH distinguish it from benign fibrous histiocytic tumors of the lung which have also been reported [ 12 – 14 ].…”

Pulmonary plasma cell granuloma—an electron microscopic and tissue culture study

“…The term 'plasma cell granuloma' has been used for a number of pulmonary lesions, all characterized by the presence of plasma cells, histiocytes, ly~nphocytes, blood vessels and other components of an inflammatory reaction (Bahadori & Liebow 1973). The similarity to granulation tissue has led some to consider this entity as an inflammatory pseudotumour (Umiker & Iverson 1954, Titus et al 1962, Val-Bernal, Garijo-Ayensa & Echevarri 1973, Vila-Torres et al 1976, and the predominance in some lesions of the histiocytic infiltrate and abundant foam cells, has justified the use of terms like xanthoma, fibroxantlioma or histiocytoina (Scott, Morrow & Payne 1948, Umiker & Iverson 1954, Viguera et al 1976, Spencer 1977.…”