Indolent Angiomatoid Fibrous Histiocytoma Mimicking a Benign Cystic Tumor
Angiomatoid fibrous histiocytoma (AFH) is a rare intermediate tumor that is often difficult to diagnose radiologically and pathologically. Herein, we report a case of AFH in the knee that was initially misdiagnosed as a cystic lesion. The tumor was first identified eight years earlier during the pat...
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2025-01-01
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| author | Jiro Ichikawa Tomonori Kawasaki Kojiro Onohara Masanori Wako Satoshi Ochiai Tetsuo Hagino Hirotaka Haro |
| author_facet | Jiro Ichikawa Tomonori Kawasaki Kojiro Onohara Masanori Wako Satoshi Ochiai Tetsuo Hagino Hirotaka Haro |
| author_sort | Jiro Ichikawa |
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| description | Angiomatoid fibrous histiocytoma (AFH) is a rare intermediate tumor that is often difficult to diagnose radiologically and pathologically. Herein, we report a case of AFH in the knee that was initially misdiagnosed as a cystic lesion. The tumor was first identified eight years earlier during the patient’s initial visit, when plain magnetic resonance imaging (MRI) was performed, leading to a diagnosis of a cystic lesion. At the current visit, the tumor had subsequently enlarged, and pain had appeared. Contrast-enhanced MRI was performed at our hospital, revealing enhancement suggestive of a solid tumor. A needle biopsy was performed, raising suspicion of AFH. Wide resection was performed, and AFH was diagnosed using histopathological findings and fluorescence in situ hybridization (FISH). Although there are several characteristic imaging findings of AFH, they are non-specific, and small tumors can be easily overlooked. Furthermore, histopathological findings lack specific immunohistochemical markers, making morphological appearance, combined with FISH findings recently reported as useful, important for preventing misdiagnosis. Since cystic lesions can occur in various locations besides the knee, it is recommended to perform contrast-enhanced MRI for accurate diagnosis when there is an increase in size or the appearance of symptoms, as plain MRI alone may lead to misdiagnosis. |
| format | Article |
| id | doaj-art-9fbdc81498b34a439865fb740cc0da18 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| series | Diagnostics |
| spelling | doaj-art-9fbdc81498b34a439865fb740cc0da182025-01-10T13:16:46ZengMDPI AGDiagnostics2075-44182025-01-0115111510.3390/diagnostics15010115Indolent Angiomatoid Fibrous Histiocytoma Mimicking a Benign Cystic TumorJiro Ichikawa0Tomonori Kawasaki1Kojiro Onohara2Masanori Wako3Satoshi Ochiai4Tetsuo Hagino5Hirotaka Haro6Department of Orthopedic Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo 409-3898, Yamanashi, JapanDepartment of Pathology, Saitama Medical University International Medical Center, Hidaka 350-1298, Saitama, JapanDepartment of Radiology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo 409-3898, Yamanashi, JapanDepartment of Orthopedic Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo 409-3898, Yamanashi, JapanDepartment of Orthopedic Surgery, National Hospital Organization (NHO) Kofu National Hospital, Kofu 400-8533, Yamanashi, JapanDepartment of Orthopedic Surgery, National Hospital Organization (NHO) Kofu National Hospital, Kofu 400-8533, Yamanashi, JapanDepartment of Orthopedic Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo 409-3898, Yamanashi, JapanAngiomatoid fibrous histiocytoma (AFH) is a rare intermediate tumor that is often difficult to diagnose radiologically and pathologically. Herein, we report a case of AFH in the knee that was initially misdiagnosed as a cystic lesion. The tumor was first identified eight years earlier during the patient’s initial visit, when plain magnetic resonance imaging (MRI) was performed, leading to a diagnosis of a cystic lesion. At the current visit, the tumor had subsequently enlarged, and pain had appeared. Contrast-enhanced MRI was performed at our hospital, revealing enhancement suggestive of a solid tumor. A needle biopsy was performed, raising suspicion of AFH. Wide resection was performed, and AFH was diagnosed using histopathological findings and fluorescence in situ hybridization (FISH). Although there are several characteristic imaging findings of AFH, they are non-specific, and small tumors can be easily overlooked. Furthermore, histopathological findings lack specific immunohistochemical markers, making morphological appearance, combined with FISH findings recently reported as useful, important for preventing misdiagnosis. Since cystic lesions can occur in various locations besides the knee, it is recommended to perform contrast-enhanced MRI for accurate diagnosis when there is an increase in size or the appearance of symptoms, as plain MRI alone may lead to misdiagnosis.https://www.mdpi.com/2075-4418/15/1/115indolentangiomatoid fibrous histiocytomacystic lesionimaginghistopathologyfluorescence in situ hybridization |
| spellingShingle | Jiro Ichikawa Tomonori Kawasaki Kojiro Onohara Masanori Wako Satoshi Ochiai Tetsuo Hagino Hirotaka Haro Indolent Angiomatoid Fibrous Histiocytoma Mimicking a Benign Cystic Tumor Diagnostics indolent angiomatoid fibrous histiocytoma cystic lesion imaging histopathology fluorescence in situ hybridization |
| title | Indolent Angiomatoid Fibrous Histiocytoma Mimicking a Benign Cystic Tumor |
| title_full | Indolent Angiomatoid Fibrous Histiocytoma Mimicking a Benign Cystic Tumor |
| title_fullStr | Indolent Angiomatoid Fibrous Histiocytoma Mimicking a Benign Cystic Tumor |
| title_full_unstemmed | Indolent Angiomatoid Fibrous Histiocytoma Mimicking a Benign Cystic Tumor |
| title_short | Indolent Angiomatoid Fibrous Histiocytoma Mimicking a Benign Cystic Tumor |
| title_sort | indolent angiomatoid fibrous histiocytoma mimicking a benign cystic tumor |
| topic | indolent angiomatoid fibrous histiocytoma cystic lesion imaging histopathology fluorescence in situ hybridization |
| url | https://www.mdpi.com/2075-4418/15/1/115 |
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