Difference between revisions of "Solitary fibrous tumour of the pleura"

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#redirect [[Lung_tumours#Solitary_fibrous_tumour_of_the_pleura]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Pleural solitary fibrous tumor (2).jpg
| Width      =
| Caption    = Pleural solitary fibrous tumour. [[H&E stain]].
| Synonyms  =
| Micro      = spindle cells usually with a bland cytology, patternless pattern, +/-ropy collagen
| Subtypes  =
| LMDDx      = CD34 +ve, CD99 +ve, BCL2 +ve, S-100 -ve
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = pleura of [[lung]]
| Assdx      =
| Syndromes  = Doege-Potter syndrome
| Clinicalhx =
| Signs      = +/-impaired respiratory function (due to mass effect)
| Symptoms  =
| Prevalence = common for site, uncommon overall
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = usu. benign
| Other      =
| ClinDDx    =
| Tx        = surgery
}}
'''Solitary fibrous tumour of the pleura''', also '''pleural solitary fibrous tumour''', is a relatively common chest wall tumour.
 
The solitary fibrous tumour in general is dealt with in the ''[[solitary fibrous tumour]]'' article.
 
==General==
*Uncommon overall<ref name=pmid24326857/> ~ 800 cases reported.<ref name=pmid17075563>{{Cite journal  | last1 = Robinson | first1 = LA. | title = Solitary fibrous tumor of the pleura. | journal = Cancer Control | volume = 13 | issue = 4 | pages = 264-9 | month = Oct | year = 2006 | doi =  | PMID = 17075563 }}</ref>
**Common for the anatomical site.
*Usually benign ~ 80% of the time.<ref name=pmid17075563/>
*Slow growing.<ref name=pmid24326857>{{Cite journal  | last1 = Mordenti | first1 = P. | last2 = Di Cicilia | first2 = R. | last3 = Delfanti | first3 = R. | last4 = Capelli | first4 = P. | last5 = Paties | first5 = C. | last6 = Cavanna | first6 = L. | title = Solitary fibrous tumors of the pleura: a case report and review of the literature. | journal = Tumori | volume = 99 | issue = 4 | pages = e177-83 | month =  | year =  | doi = 10.1700/1361.15120 | PMID = 24326857 }}</ref>
*Elderly.
*May be large - impair respiratory function.<ref name=pmid24088920>{{Cite journal  | last1 = Abe | first1 = M. | last2 = Nomori | first2 = H. | last3 = Fukazawa | first3 = M. | last4 = Sugimura | first4 = H. | last5 = Narita | first5 = M. | last6 = Takeshi | first6 = A. | title = Giant Solitary Fibrous Tumor of the Pleura Causing Respiratory Insufficiency: Report of 3 Cases. | journal = Ann Thorac Cardiovasc Surg | volume =  | issue =  | pages =  | month = Oct | year = 2013 | doi =  | PMID = 24088920 }}</ref>
*May be associated with hypoglycemia.
**Known as ''Doege-Potter syndrome''.<ref name=pmid1474302>{{Cite journal  | last1 = Roy | first1 = TM. | last2 = Burns | first2 = MV. | last3 = Overly | first3 = DJ. | last4 = Curd | first4 = BT. | title = Solitary fibrous tumor of the pleura with hypoglycemia: the Doege-Potter syndrome. | journal = J Ky Med Assoc | volume = 90 | issue = 11 | pages = 557-60 | month = Nov | year = 1992 | doi =  | PMID = 1474302 }}</ref>
 
==Gross/radiology==
*Chest wall mass.
**May be "large".<ref name=pmid17075563/>
 
==Microscopic==
Features:
*Spindle cells - usually bland cytology.
*Patternless pattern.
*+/-Ropy collagen.
*[[Staghorn vessels]].
 
Suggestive of malignant:<ref name=pmid24088920/>
*Mitotic rate >4/10 HPF.
**Definition suffers from [[HPFitis]].
 
DDx:
*[[Malignant mesothelioma]].
*Metastatic carcinoma.
*[[Lung adenocarcinoma]].
 
===Images===
<gallery>
Image:Pleural solitary fibrous tumor (1).jpg | Pleural SFT. (WC)
Image:Pleural solitary fibrous tumor (2).jpg | Pleural SFT. (WC)
Image:Pleural solitary fibrous tumor (3).jpg | Pleural SFT. (WC)
</gallery>
www:
*[http://path.upmc.edu/cases/case216/dx.html SFT (upmc.edu)].
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698259/figure/f2/ Pleural SFT (nih.gov)].<ref name=pmid23825765/>
 
==IHC==
Features:
*CD34 +ve (19/23 cases<ref name=pmid15460417>{{Cite journal  | last1 = Chen | first1 = HJ. | last2 = Zhang | first2 = HY. | last3 = Li | first3 = X. | last4 = Guo | first4 = LX. | last5 = Wei | first5 = B. | last6 = Guo | first6 = H. | last7 = Bu | first7 = H. | last8 = Yang | first8 = K. | last9 = Liu | first9 = BL. | title = [Solitary fibrous tumor: the clinicopathologic and immunohistochemical characteristics of 26 cases]. | journal = Sichuan Da Xue Xue Bao Yi Xue Ban | volume = 35 | issue = 5 | pages = 675-9 | month = Sep | year = 2004 | doi =  | PMID = 15460417 }}</ref>).
*Ki-67 low (<5%).<ref name=pmid24088920/>
*Vimentin +ve (23/23 cases<ref name=pmid15460417/>).
*BCL2 +ve (23/23 cases<ref name=pmid15460417/>).
*CD99 +ve (23/23 cases<ref name=pmid15460417/>).
*SMA -ve/+ve (7 +ve/23 cases<ref name=pmid15460417/>).
 
Others:
*WT1 -ve (+ve in 1 of 10 cases<ref name=pmid18528287>{{Cite journal  | last1 = Bing | first1 = Z. | last2 = Pasha | first2 = TL. | last3 = Acs | first3 = G. | last4 = Zhang | first4 = PJ. | title = Cytoplasmic overexpression of WT-1 in gastrointestinal stromal tumor and other soft tissue tumors. | journal = Appl Immunohistochem Mol Morphol | volume = 16 | issue = 4 | pages = 316-21 | month = Jul | year = 2008 | doi = 10.1097/PAI.0b013e31815c2e02 | PMID = 18528287 }}</ref>).
*Desmin -ve.<ref name=pmid23825765>{{Cite journal  | last1 = Zhu | first1 = Y. | last2 = Du | first2 = K. | last3 = Ye | first3 = X. | last4 = Song | first4 = D. | last5 = Long | first5 = D. | title = Solitary fibrous tumors of pleura and lung: report of twelve cases. | journal = J Thorac Dis | volume = 5 | issue = 3 | pages = 310-3 | month = Jun | year = 2013 | doi = 10.3978/j.issn.2072-1439.2013.05.19 | PMID = 23825765 }}</ref>
*CD117 -ve.<ref name=pmid23825765/>
 
Suggested stains:{{fact}}
*CD34, CD99, BCL2, S-100, Ki-67.
 
==Sign out==
<pre>
LEFT LUNG ("LARGE PLEURAL BASED MASS"), BIOPSY:
- SOLITARY FIBROUS TUMOUR.
</pre>
 
===Micro===
The sections show cellular fibrous tissue with a patternless pattern. Rare staghorn vessels are present. No mitotic activity is readily apparent. No significant nuclear atypia is identified. No necrosis is apparent.
 
==See also==
*[[Solitary fibrous tumour]].
 
==References==
{{Reflist|2}}
 
[[Category:Diagnosis]]
[[Category:Lung tumours]]

Latest revision as of 20:51, 20 February 2014

Solitary fibrous tumour of the pleura
Diagnosis in short

Pleural solitary fibrous tumour. H&E stain.
LM spindle cells usually with a bland cytology, patternless pattern, +/-ropy collagen
LM DDx CD34 +ve, CD99 +ve, BCL2 +ve, S-100 -ve
Site pleura of lung
Syndromes Doege-Potter syndrome
Signs +/-impaired respiratory function (due to mass effect)
Prevalence common for site, uncommon overall
Prognosis usu. benign
Treatment surgery

Solitary fibrous tumour of the pleura, also pleural solitary fibrous tumour, is a relatively common chest wall tumour.

The solitary fibrous tumour in general is dealt with in the solitary fibrous tumour article.

General

  • Uncommon overall[1] ~ 800 cases reported.[2]
    • Common for the anatomical site.
  • Usually benign ~ 80% of the time.[2]
  • Slow growing.[1]
  • Elderly.
  • May be large - impair respiratory function.[3]
  • May be associated with hypoglycemia.
    • Known as Doege-Potter syndrome.[4]

Gross/radiology

  • Chest wall mass.
    • May be "large".[2]

Microscopic

Features:

  • Spindle cells - usually bland cytology.
  • Patternless pattern.
  • +/-Ropy collagen.
  • Staghorn vessels.

Suggestive of malignant:[3]

  • Mitotic rate >4/10 HPF.

DDx:

Images

  • Pleural SFT. (WC)

  • Pleural SFT. (WC)

  • Pleural SFT. (WC)

www:

IHC

Features:

  • CD34 +ve (19/23 cases[6]).
  • Ki-67 low (<5%).[3]
  • Vimentin +ve (23/23 cases[6]).
  • BCL2 +ve (23/23 cases[6]).
  • CD99 +ve (23/23 cases[6]).
  • SMA -ve/+ve (7 +ve/23 cases[6]).

Others:

  • WT1 -ve (+ve in 1 of 10 cases[7]).
  • Desmin -ve.[5]
  • CD117 -ve.[5]

Suggested stains:[citation needed]

  • CD34, CD99, BCL2, S-100, Ki-67.

Sign out

LEFT LUNG ("LARGE PLEURAL BASED MASS"), BIOPSY:
- SOLITARY FIBROUS TUMOUR.

Micro

The sections show cellular fibrous tissue with a patternless pattern. Rare staghorn vessels are present. No mitotic activity is readily apparent. No significant nuclear atypia is identified. No necrosis is apparent.

See also

References

  1. ↑ 1.0 1.1 Mordenti, P.; Di Cicilia, R.; Delfanti, R.; Capelli, P.; Paties, C.; Cavanna, L.. "Solitary fibrous tumors of the pleura: a case report and review of the literature.". Tumori 99 (4): e177-83. doi:10.1700/1361.15120. PMID 24326857.
  2. ↑ 2.0 2.1 2.2 Robinson, LA. (Oct 2006). "Solitary fibrous tumor of the pleura.". Cancer Control 13 (4): 264-9. PMID 17075563.
  3. ↑ 3.0 3.1 3.2 Abe, M.; Nomori, H.; Fukazawa, M.; Sugimura, H.; Narita, M.; Takeshi, A. (Oct 2013). "Giant Solitary Fibrous Tumor of the Pleura Causing Respiratory Insufficiency: Report of 3 Cases.". Ann Thorac Cardiovasc Surg. PMID 24088920.
  4. ↑ Roy, TM.; Burns, MV.; Overly, DJ.; Curd, BT. (Nov 1992). "Solitary fibrous tumor of the pleura with hypoglycemia: the Doege-Potter syndrome.". J Ky Med Assoc 90 (11): 557-60. PMID 1474302.
  5. ↑ 5.0 5.1 5.2 Zhu, Y.; Du, K.; Ye, X.; Song, D.; Long, D. (Jun 2013). "Solitary fibrous tumors of pleura and lung: report of twelve cases.". J Thorac Dis 5 (3): 310-3. doi:10.3978/j.issn.2072-1439.2013.05.19. PMID 23825765.
  6. ↑ 6.0 6.1 6.2 6.3 6.4 Chen, HJ.; Zhang, HY.; Li, X.; Guo, LX.; Wei, B.; Guo, H.; Bu, H.; Yang, K. et al. (Sep 2004). "[Solitary fibrous tumor: the clinicopathologic and immunohistochemical characteristics of 26 cases].". Sichuan Da Xue Xue Bao Yi Xue Ban 35 (5): 675-9. PMID 15460417.
  7. ↑ Bing, Z.; Pasha, TL.; Acs, G.; Zhang, PJ. (Jul 2008). "Cytoplasmic overexpression of WT-1 in gastrointestinal stromal tumor and other soft tissue tumors.". Appl Immunohistochem Mol Morphol 16 (4): 316-21. doi:10.1097/PAI.0b013e31815c2e02. PMID 18528287.
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