Surgical Pathology Criteria–

Plexiform Fibrohistiocytic Tumor

Differential Diagnosis

Dermal and Deep Fibrous Histiocytoma Plexiform Fibrohistiocytic Tumor
No plexiform rays of fibrous tissue extending into fat Plexiform rays of fibrous tissue extending into fat
Histiocytes scattered throughout Nodules of histiocyte-like cells
Frequent xanthoma cells Xanthoma cells rare
Extravasated red blood cells infrequent Extravasated red blood cells frequent

 

Plexiform Fibrohistiocytic Tumor Nodular Fasciitis
More mature collagenous stroma Loose, immature stroma
Small, dense nuclei Vesicular nuclei
Mitotic figures usually rare Mitotic figures frequent
Nodules of histiocytes frequent Foam cells and histiocytes infrequent
Plexiform rays of fibrous tissue Loose C and S shaped bundles of cells

 

Fibrous Hamartoma of Infancy Plexifiorm Fibrohistiocytic Tumor
Myxoid stroma Fibrous stroma
Foci of immature cells Nodules of histiocyte-like cells
No multinucleated cells Frequent multinucleated cells in nodules

 

Fibromatosis, Abdominal Desmoid, Extra-abdominal Desmoid Plexifiorm Fibrohistiocytic Tumor
Diffuse infiltrative pattern Plexiform and nodular pattern
No nodules of histiocytes and giant cells Nodules of histiocyte-like cells and multinucleated giant cells
Wider, longer fascicles Shorter fascicles
Centered in muscle Centered in subcutis

 

Soft Tissue Giant Cell Tumor of Low Malignant Potential Plexifiorm Fibrohistiocytic Tumor
Mixed giant and spindled cells but not distinctly biphasic Biphasic with nodules of histiocyte-like cells with giant cells and spindled fibroblastic areas
Infiltrating nodules Plexiform infiltrative pattern
Frequent mitotic figures Mitotic figures rare

 

Plexiform Fibrohistiocytic Tumor Dermatofibrosarcoma Protuberans
Ray-like extension into surrounding fat Infiltrates between and around individual fat cells
Collagenous stroma Usually contains only fine collagen
Nodules of histiocytes and giant cells in most cases Histiocytes and giant cells very rare
CD34 negative CD34 stains lesional cells
 

 

Plexiform Neurofibroma Plexifiorm Fibrohistiocytic Tumor
S100 positive S100 negative
No nodules of histiocytes and giant cells Nodules of histiocyte-like cells and multinucleated giant cells

 

Myofibroma Plexifiorm Fibrohistiocytic Tumor
Circumscribed Plexiform rays infiltrate fat
Central primitive dark cells with hemangiopericytoma-like vessels Nodules with histiocyte-like cells and multinucleated cells

 

Plexiform Fibrohistiocytic Tumor Giant Cell Fibroblastoma
Ray-like extension of fibrous tissue into surrounding fat Infiltrates between and around individual fat cells
Lacks pseudovascular spaces Pseudovascular spaces present
Nodules of histiocytes and giant cells in most cases Scattered individual giant cells
CD34 negative CD34 stains lesional cells

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