Malignant fibrous histiocytoma in bone infarct. Association with sickle cell trait and alcohol abuse.

A 42-year-old black man with sickle cell trait and a history of alcohol abuse had a malignant fibrous histiocytoma of the distal femur. The tumor developed in a bone infarct that had been present for at least 54 months. This is the first reported association of malignant fibrous histiocytoma and bone infarct in which the infarct was related to sickle cell trait and alcohol abuse. A detailed map of the sections from the resected femur disclosed a spectrum of cytologic changes in the sarcoma that ranged from bland fibroblasts in the center of the tumor to high-grade sarcoma at the periphery. Awareness of this spectrum has diagnostic importance regarding the potential underdiagnosis of well-differentiated malignant fibrous histiocytoma.