Dermatopathology

Benign Fibrous Histiocytoma

Benign Fibrous Histiocytoma is a rare tumor characterized by lipid-filled cells or slow-growing gray, yellow, white or red bumps. It may cause localized pain or itching but is usually not aggressive.

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Slide 1: 60 year-old man with a 0.7 cm right lateral calf pink/grey crusted papule.

Slide 2: There is a central ulcer. The adjacent epidermis appears hyperplastic and is surmounted by a relatively normal appearing stratum corneum. Underlying the ulcer is a spindle cell proliferation.

Slide 3: The lesion is hypercellular and is composed of spindled cells and intermingled inflammatory cells.

Slide 4: This vasoformative lesion is composed of relatively uniform appearing cells with round to oval nuclei and inconspicuous nucleoli. They are interposed by blood vessels that have prominent basement membrane zones. An HHV-8 stain was negative, ruling out Kaposi's sarcoma.

Slide 5: The findings are in keeping with a sclerosing hemangioma/benign fibrous histiocytoma.