Malignant Fibrous Histiocytoma: Diagnostic Tests

Obligatory medical device diagnostics.

  • Conventional radiography of the affected body region, in two planes – to assess the extent of tumor growth; malignant (malignant) fibrous histiocytoma is usually well demarcated and may contain calcifications
  • Computed tomography (CT; cross-sectional imaging (radiographs taken from different directions with computer-based evaluation)) – for the purpose of determining tumor location, size, and extent (bone destruction/destruction? ), rate of growth (aggressiveness), and to detect skip metastases (nearby metastases)
  • Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging (using magnetic fields, i.e., without X-rays)) – for the purpose of determining the location, size, and extent of the tumor (soft tissue infiltration? intramedullary spread in the bone marrow? Involvement of the spinal canal?) and for the detection of skip metastases (nearby metastases).
  • Sonography (ultrasound examination), if necessary – to characterize palpable (palpable) masses in the retroperitoneum (space located behind the peritoneum on the back toward the spine) or abdomen (abdominal cavity)

Diagnosis of spread (“staging”) (metastasis?) – if the suspected diagnosis of a bone tumor has been confirmed.

  • Computed tomography of the thorax (thoracic CT) – to detect distant metastases in the lungs (90%), liver (1%).
  • Skeletal scintigraphy (nuclear medicine procedure that can represent functional changes in the skeletal system, in which regionally (locally) pathologically (pathologically) increased or decreased bone remodeling processes are present) – to detect metastases in other areas of the skeleton (8%).
  • If necessary, positron emission tomography (PET) – to detect distant metastases.

Lodwick classification

By means of 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
  • A
Very slow growing Sclerosis (pathological hardening of here: tissues) and sharp boundary benign Chondroblastoma, enchondroma, fibrous bone dysplasia, nonossifying fibroma, osteoid osteoma
  • B
Slow growing (displacing) Bone distention > 1 cm and/or no sclerosis actively benign Giant cell tumor
  • C
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 that further diagnostic measures are usually indispensable.