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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
KNOW THIS FIELD Table of Contents   
Year : 2006  |  Volume : 10  |  Issue : 1  |  Page : 9
 

Know this field


Department of Oral and Maxillo Facial Pathology, Meenakshi Ammal dental college and hospital, Chennai, India

Correspondence Address:
B Kavitha
Department of Oral and Maxillo Facial Pathology, Meenakshi Ammal dental college and hospital, Chennai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-029X.37744

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How to cite this article:
Kavitha B, Sivakumar G, Saraswathi T R. Know this field. J Oral Maxillofac Pathol 2006;10:9

How to cite this URL:
Kavitha B, Sivakumar G, Saraswathi T R. Know this field. J Oral Maxillofac Pathol [serial online] 2006 [cited 2019 Nov 13];10:9. Available from: http://www.jomfp.in/text.asp?2006/10/1/9/37744


Case details

A 22-year-old male patient reported with a swelling of left lower jaw of 1 %2 months duration. On clinical examination, a diffuse bony swelling extended from 34 region to coronoid process. Multiple radiolucency seen in left side of the mandible.

Microscopic findings

  • Pleomorphic cells arranged in intersecting fascicles in storiform pattern
  • Altered N/C ratio and mitotic figures
  • Focal myxoid areas with numerous multinucleated giant cells
  • Chronic inflammatory cell infiltrate, predominantly lymphocytes
  • Occasional rounded histiocytes
  • Stroma with delicate collagen network


Provisional diagnosis

Malignant fibrous histiocytoma (MFH)

Differential diagnosis

Pleomorphic liposarcoma

  • Usually lacks a distinct whorled / storiform pattern
  • Contains less stromal collagen
  • Vacuolated lipoblasts with scalloped nuclei seen in contrast to the finely dispersed fat and undisplaced nucleus in histiocytes of MFH


Pleomorphic rhabdomyosarcoma

  • Cells have uniform and deeply eosinophilic cytoplasm, longitudinal striations with less interstitial collagenization


Fibrosarcoma

  • Cells are uniformly spindle shaped and vary little in size and shape
  • Multinucleated giant cells is a rare feature of this tumour
  • Marked nuclear pleomorphism is more suggestive of MFH than fibrosarcoma


MPNST (Malignant peripheral nerve sheath tumour)

  • Cells have a wavy appearance compared to the finely tapered fibroblasts
  • Long sweeping fascicles are usually not present
  • Cartilagenous metaplasia is more frequent than any other non-cartilagenous neoplasm


Fibroblastic Osteosarcoma

  • Tumour cells are spindle shaped with focal areas of matrix production


Dediffentiated Chondrosarcoma

  • Lobules of hyaline cartilage juxtaposed with spindle cell foci


Absence of vacuolated lipoblasts, striated cells, wavy nucleated cells, focal areas of matrix formation and cartilaginous areas rule out above said lesions.

Final diagnosis

Malignant fibrous histiocytoma (Pleomorphic - storiform variant)


    Figures

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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
Online since 15th Aug, 2007