Solitary fibrous tumour of pleura

Case contributed by Dr Abdallah Khateeb

Presentation

Abnormal chest X-ray.

Patient Data

Age: 35 years old
Gender: Male
X-ray

A smooth soft tissue opacity that is silhouetting the left heart border and demonstrates the hilum overlay sign.

The lung fields are unremarkable.

Further assessment with CT was performed.

Well defined anterior mediastinal mass, with peripheral enhancement and patchy low attenuation central regions.

No lymphadenopathy. No significant mass effect.

Surgical excision was performed following an inadequate core biopsy.

Case Discussion

Although the age of the patient was atypical for a solitary fibrous tumor, it is among the less likely mediastinal masses.

As these tumors are rare, the diagnosis was histopathological.

HISTOPATHOLOGY

Microscopic examination
- Well circumscribed tumor composed of alternating hypocellular and hypercellular areas of bland looking spindle cells with abundunt ropy collagen bundles in between. Dilated vascular spaces are also seen. No atypia, mitosis or necrosis is seen. The tumor cells are immunopositive for CD34, C99 and BCL2 while are negative for SMA, desmin, EMA, S100 and CD5 immunohistochemical stains.

Diagnosis
- Solitary fibrous tumor.

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Case information

rID: 44946
Case created: 9th May 2016
Last edited: 16th Jul 2017
System: Chest
Inclusion in quiz mode: Included

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