Malignant fibrous histiocytoma of bone: conventional X-ray and MR imaging features.

OBJECTIVE

To evaluate the conventional X-ray and MR imaging features of malignant fibrous histiocytoma (MFH) of bone.

DESIGN

MRI examinations and conventional radiographs were reviewed in 39 patients with biopsy-proven MFH. Imaging characteristics were analyzed and the differential diagnoses assessed in a masked fashion by two experienced radiologists.

RESULTS

Typical X-ray features included aggressive, destructive tumor growth centrally located in the metaphysis of long bones. Periosteal reactions and expansive growth were rarely seen. On MR images extraosseous tumor spread was frequently noted. On T2-weighted images and contrast-enhanced T1-weighted images most of the tumors displayed an inhomogeneous, nodular signal pattern with peripheral Gd-DTPA enhancement.

CONCLUSIONS

Although several MR imaging criteria were typical for MFH none of them was specific. X-ray diagnosis of MFH may also prove difficult, with the main differential diagnosis being metastasis in the older and osteosarcoma in the younger population.