本文报告10例恶性纤维组织细胞瘤。组织学上将其分为花瓣型(3例)、巨细胞型(3例)及混合型(4例)。文中讨论了本瘤的恶性诊断标准及鉴别诊断。本文5例病程少于6月,9例体积大于5cm。镜检有出血坏死灶、呈花瓣状排列的兼性成纤维细胞及具有吞噬能力的组织细胞。核分裂象丰富(平均31个/50高倍视野),细胞及胞核有多形性。在随访到的7例中,6例复发,3例术后短期内死亡,1例4次复发后肺转移。根据这些观察提示,本文所报告的病例均为恶性病变。在组织学上,本瘤应与良性纤维组织细胞瘤、隆突性皮肤纤维肉瘤、皮肤非典型纤维黄色瘤及上皮样肉瘤相鉴别。文末对组织细胞源性肿瘤的分类与命名进行了讨论。 This article reports 10 cases of malignant fibrous histiocytoma. Histologically, it was divided into three types: petal type (3 cases), giant cell type (3 cases) and mixed type (4 cases). This article discusses the malignant diagnostic criteria and differential diagnosis of this tumor. In this article, the course of the disease in 5 cases was less than 6 months, and the volume in 9 cases was greater than 5 cm. Microscopically, there were hemorrhagic and necrotic foci, petal-like facultative fibroblasts, and phagocytic tissue cells. Mitochondria are abundant (average 31/50 high-power fields), and cells and nuclei are polymorphic. Of the 7 patients followed up, 6 relapsed, 3 died shortly after surgery, and 1 had recurrent lung metastases 4 times. According to these observations, the cases reported here are all malignant. Histologically, this tumor should be differentiated from benign fibrous histiocytoma, protrusive dermal sarcoma, atypical fibrous xanthoma and epithelioid sarcoma. At the end of the paper, the classification and naming of histiocyte-derived tumors were discussed.