Surgical Pathology Criteria–

Angiomatoid Fibrous Histiocytoma

Differential Diagnosis

Metastatic Mesenchymal Neoplasm in a Lymph Node Angiomatoid Fibrous Histiocytoma
Typical nodal architecture Lacks subcapsular sinus and efferent hilar lymphatics
Typical nodal location Frequently in a site where a lymph node would be unusual
Usually has cytologic atypia Usually quite bland
Blood filled cystic spaces unusual for most neoplasms Frequent blood filled cystic spaces

 

Angiosarcoma Angiomatoid Fibrous Histiocytoma
Usually dermal Usually subcutaneous
Usually demonstrates endothelial tufting Cystic spaces lack endothelial lining
CD31 and CD34 positive in most cases CD31 and CD34 negative
Desmin negative Desmin positive in 50% of cases

 

Kaposi Sarcoma Angiomatoid Fibrous Histiocytoma
Usually dermal Usually subcutaneous
Slit-like blood filled spaces Cystic blood filled spaces
CD31 and CD34 positive in most cases CD31 and CD34 negative
Desmin negative Desmin positive in 50% of cases

 

Aneurysmal (Angiectoid)Benign Dermal Fibrous Histiocytoma Angiomatoid Fibrous Histiocytoma
Usually dermal Usually subcutaneous
Lacks fibrous capsule Usually has fibrous capsule
Lacks surrounding lympho-plasmacytic infiltrate Usually has prominent lympho-plasmacytic infiltrate
Frequent overlying epidermal hyperplasia Lacks epidermal hyperplasia
Lacks prominent round cell component Usually has prominent round cell component
Foam cells and giant cells frequent Foam cells and giant cells infrequent
Desmin negative Desmin positive in 50% of cases

 

Rhabdomyosarcoma Angiomatoid Fibrous Histiocytoma
Infiltrative Circumscribed
Lacks surrounding lympho-plasmacytic infiltrate Usually has prominent lympho-plasmacytic infiltrate
Strap cells and/or rhabdoid cytoplasm Scant cytoplasm
Blood filled cystic spaces unusual Frequent blood filled cystic spaces
MyoD1, myoglobin, myogenin positive MyoD1, myoglobulin, myogenin negative

 

Diffuse Tenosynovial Giant Cell Tumor Angiomatoid Fibrous Histiocytoma
Cystic spaces lack blood Cystic blood filled spaces
Numerous giant cells Infrequent giant cells
Scant desmin reactivity May have extensive, strong desmin expression

 

Vascular Malformation / Hemangioma Angiomatoid Fibrous Histiocytoma
Cystic spaces lined by endothelium Cystic spaces not lined by endothelium
Lacks round/spindle cell component Prominent round/spindle cell component

 

Inflammatory Myofibroblastic Tumor Angiomatoid Fibrous Histiocytoma
Blood filled cystic spaces unusual Frequent blood filled cystic spaces
Inflammatory infiltrate usually contains neutrophils Neutrophils unusual in infiltrate

 

Hemangiopericytoma Angiomatoid Fibrous Histiocytoma
Stag horn vascular spaces lined by endothelium Cystic spaces not lined by endothelium
CD34 positive 50% CD34 negative
Desmin negative Desmin positive 50%

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