Indolent Angiomatoid Fibrous Histiocytoma Mimicking a Benign Cystic Tumor.

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Diagnostics Pub Date : 2025-01-06 DOI:10.3390/diagnostics15010115
Jiro Ichikawa, Tomonori Kawasaki, Kojiro Onohara, Masanori Wako, Satoshi Ochiai, Tetsuo Hagino, Hirotaka Haro
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Abstract

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.

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模拟良性囊性肿瘤的无痛血管瘤样纤维组织细胞瘤。
血管瘤样纤维组织细胞瘤(AFH)是一种罕见的中间肿瘤,通常难以放射学和病理学诊断。在此,我们报告一例AFH在膝盖,最初被误诊为囊性病变。肿瘤是在八年前患者首次就诊时发现的,当时进行了普通磁共振成像(MRI)检查,诊断为囊性病变。在这次就诊时,肿瘤随后扩大,并出现疼痛。在我院进行MRI增强检查,发现强化提示有实体瘤。行穿刺活检,怀疑为AFH。进行广泛切除,并通过组织病理学检查和荧光原位杂交(FISH)诊断AFH。虽然AFH有几个特征性的影像学表现,但它们是非特异性的,小肿瘤很容易被忽视。此外,组织病理学结果缺乏特异性免疫组织化学标记,使得形态学外观,结合最近报道的FISH结果是有用的,对防止误诊很重要。由于囊性病变可发生在除膝关节外的其他部位,因此当出现体积增大或症状出现时,建议行MRI增强扫描以准确诊断,单纯MRI平扫可能导致误诊。
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来源期刊
Diagnostics
Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry
CiteScore
4.70
自引率
8.30%
发文量
2699
审稿时长
19.64 days
期刊介绍: Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.
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