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2009, Volume 25, Number 3, Page(s) 126-131
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DOI: 10.5146/tjpath.2009.01167 |
Pleural Giant Solitary Fibrous Tumor and Immunohistochemical Profile |
Nalan NEŞE1, Sadık YALDIZ2, Gülgün OVALI3, Aydın İŞİSAĞ1 |
Celal Bayar Üniversitesi, Tıp Fakültesi, 1Patoloji, 2Göğüs Cerrahisi, 3Radyodiagnostik Anabilim Dalları, MANİSA, TÜRKİYE Departments of 1Pathology, 2Chest Surgery and 3Radiodiagnostics, Celal Bayar University, Faculty of Medicine, MANISA, TURKEY |
Keywords:
Solitary fibrous tumor, CD34, Pleura |
Pleural solitary fibrous tumor is a rare and slow growing intrathoracic
neoplasm. It originates from submesenchymal cells of parietal
or, more commonly, visceral pleura. Although most cases follow a
benign clinical course, it has been reported that a malignant outcome
is seen in 7,5-37% of cases. We present here a case considered as
pleural solitary fibrous tumor with malignant potential. A 74-yearold
woman presented with dyspnea and computerized tomography
showed a mediastinal mass connected to the pleura. The tumor
was removed by surgery. Grossly, the tumor was lobulated, welldemarcated
and mostly encapsulated. Its weight was 754 gr. and it
measured 17x12x5.5 cm. The cut surface had a whorled appearance.
Focal necrosis and myxoid degenerative areas were noted.
Histopathologically, hypocellular areas characterized by uniform,
small spindle cells in a collagen rich stroma and hypercellular areas
were seen. The tumor had a prominent branching vascular network.
Although mitosis was infrequent, necrosis was common. Tumoral
cells were strongly immunoreactive for CD34, bcl-2 and vimentin by
immunohistochemistry. Cytokeratin, actin, S100, CD117 and desmin
were negative. The ratio of Ki-67 positive cells was 10%. The patient
was diagnosed as pleural solitary fibrous tumor with malignant
potential because of hypercellularity and presence of large necrotic
areas although increased mitosis and pleomorphism were almost
absent. There was no recurrence or metastasis 15 months after the
surgery.
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