Investig Magn Reson Imaging.  2016 Dec;20(4):264-268. 10.13104/imri.2016.20.4.264.

Benign Fibrous Histiocytoma with Cystic Change of the Femur: a Case Report

• Park JA
• Moon SG
• Kim NR

• KMID: 2366410
• DOI: http://doi.org/10.13104/imri.2016.20.4.264

Abstract

Benign fibrous histiocytoma (BFH) is a rare benign primary skeletal tumor that occurs commonly in the long bones, spine and pelvis. BFH constitutes a diagnostic challenge because it shares clinical background, radiological characteristics, and histological features with other fibrous lesions such as non-ossifying fibroma, giant cell tumor. We present a case of BFH with cystic change that occurred in the distal femur. We did not identify any case of BFH with cystic change involving the majority of the lesion that occurred in the metaepiphysis of the long bone.

Keyword

Benign fibrous histiocytoma; Femur; Hemorrhage; Primary bone tumor

MeSH Terms

Femur*
Fibroma
Giant Cell Tumors
Hemorrhage
Histiocytoma, Benign Fibrous*
Pelvis
Spine

Figure

• 

  Fig. 1 Plain radiograph demonstrated an eccentrically located, and radiolucent lesion in the metaepiphysis of the distal femur. The lateral cortex was thinned and expansile. The osteolytic lesion had a partially marginal sclerosis along the medial border without intralesional matrix mineralization.

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  Fig. 2 Magnetic resonance imaging of BFH of the distal femur. (a) Coronal proton density-weighted image with fat suppression demonstrated an expansile heterogeneous mass in lateral aspect of the metaphysis of the distal femur extending to the epiphysis. The majority of the mass consists of intermediate hyperintense lesion with curvilinear, hyperintense component superiorly. (b) On T1-weighted coronal image, the majority of the mass appeared hyperintense, but the curvilinear part revealed hypointense superiorly. (c) On postcontrast image, the superior part of the mass showed strong enhancement meaning solid component, and the majority part of the mass showed no enhancement suggesting hemorrhagic component.

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  Fig. 3 Bone scan showed an intense radiotracer uptake in left distal femur.

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  Fig. 4 Surgical specimens revealed several fragments of gray-brown-colored, irregular solid components with overt hemorrhage occupying the majority of the mass.

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