According to localization, malignant fibrous histiocytoma (MFH) is classified as follows:
- Retroperitoneal type (retroperitoneum = space located behind the peritoneum on the back toward the spine).
- MFH of the extremities (along the muscles and fascia).
- Dermal/cutaneous (affecting the skin) sarcoma.
Histologically, the following types can be separated from the original group of malignant fibrous histiocytomas based on demonstrated residual differentiation:
- Storiform pleomorphic type (73% of cases).
- Myxoid type (19.5%)
- Giant cell type (3%)
- Xanthogranulomatous-angiomatoid type (2.5%)
- Inflammatory (inflammatory) type (2 %)
Thus, only pleomorphic sarcomas (cells with different appearance on) without clearly assignable cell differentiation are grouped under a malignant fibrous histiocytoma.
Lodwick classification
Using the Lodwick classification, it is possible to assess whether the tumor is benign (benign) or malignant (malignant) on an x-ray. Furthermore, it is suitable for the assessment of progression in the case of aggressive behavior of the tumor.
An index for the growth rate of the bone tumor or an inflammatory process is the reaction visible on the X-ray, i.e. the bone structure is modified locally, regionally or diffusely by the tumor. The visible patterns of destruction are classified into the following main groups:
| Grade | Growth rate | Bone destruction | Dignity | Bone tumors |
| Grade I | Purely geographic (circumscribed); boundary definable | |||
|
Very slow growing | Sclerosis (pathological hardening of here: tissues) and sharp boundary | benign | Chondroblastoma, enchondroma, fibrous bone dysplasia, nonossifying fibroma, osteoid osteoma |
|
Slow growing (displacing) | Bone distention > 1 cm and/or no sclerosis | actively benign | Giant cell tumor |
|
Mean growth rate(locally invasive) | Total compact penetration (compacta = outer marginal layer of bone). | aggressive benign | chondro-, osteo-, fibrosarcomas |
| Grade II | fast growing | Geographic, with moth-eaten/permeated (without respect for anatomical boundaries) component | predominantly malignant | Chondrosarcoma, fibrosarcoma, malignant fibrous histiocytoma, metastases, osteosarcoma |
| Grade III | very fast growing | purely moth-eaten or permeative destruction | malignant | Ewing’s sarcoma |
The classification is particularly suitable for tumors of a long bone or small bone. However, it is neither sensitive nor specific, so further diagnostic measures are usually indispensable.
