Solitary fibrous tumour of the pleura: Difference between revisions
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{{ 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. | '''Solitary fibrous tumour of the pleura''', also '''pleural solitary fibrous tumour''', is a relatively common chest wall tumour. | ||
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==General== | ==General== | ||
*Uncommon overall.<ref name= | *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. | **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> | *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. | *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 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== | ==Gross/radiology== | ||
*Chest wall. | *Chest wall mass. | ||
**May be "large".<ref name=pmid17075563/> | |||
==Microscopic== | ==Microscopic== | ||
| Line 19: | Line 53: | ||
*Patternless pattern. | *Patternless pattern. | ||
*+/-Ropy collagen. | *+/-Ropy collagen. | ||
*[[Staghorn vessels]]. | |||
Suggestive of malignant:<ref name=pmid24088920/> | Suggestive of malignant:<ref name=pmid24088920/> | ||
| Line 37: | Line 72: | ||
www: | www: | ||
*[http://path.upmc.edu/cases/case216/dx.html SFT (upmc.edu)]. | *[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== | ==IHC== | ||
| Line 46: | Line 82: | ||
*CD99 +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/>). | *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}} | Suggested stains:{{fact}} | ||
| Line 57: | Line 98: | ||
===Micro=== | ===Micro=== | ||
The sections show cellular fibrous tissue with a patternless pattern. No mitotic activity is readily apparent. No significant nuclear atypia is identified. No necrosis is apparent. | 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== | ==See also== | ||
Latest revision as of 20:51, 20 February 2014
| Solitary fibrous tumour of the pleura | |
|---|---|
| Diagnosis in short | |
.jpg) 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.
- Definition suffers from HPFitis.
DDx:
- Malignant mesothelioma.
- Metastatic carcinoma.
- Lung adenocarcinoma.
Images
-
Pleural SFT. (WC) -
Pleural SFT. (WC) -
Pleural SFT. (WC)
.jpg)
.jpg)
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:
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
- ↑ 1.0 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.
- ↑ 2.0 2.1 2.2 Robinson, LA. (Oct 2006). "Solitary fibrous tumor of the pleura.". Cancer Control 13 (4): 264-9. PMID 17075563.
- ↑ 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.
- ↑ 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.
- ↑ 5.0 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.
- ↑ 6.0 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.
- ↑ 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.