Solitary fibrous tumour of the pleura

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.
  • Common for the anatomical site.
• Usually benign.
• Slow growing.
• Elderly.
• May be large - impair respiratory function.
• May be associated with hypoglycemia.
  • Known as Doege-Potter syndrome.

Gross/radiology

• Chest wall mass.

Microscopic

Features:

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

Suggestive of malignant:

• 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)

www:

• SFT (upmc.edu).

IHC

Features:

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

Others:

• WT1 -ve (+ve in 1 of 10 cases).
• Desmin -ve.

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

• Solitary fibrous tumour.