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The Potential Malignancy of a Solitary Fibrous Tumour of the Lung.

Shukla R, Patrini D, Borg E, Lawrence D, Hayward M, Panagiotopoulos N - Case Rep Pathol (2015)

Bottom Line: Solitary fibrous tumours (SFTs) are rare neoplasms that in the majority of cases are benign.We present the case of a 52-year-old male, with a 23-year history of a slow growing pleural mass, presenting to our department with worsening dyspnoea and localised chest discomfort.The purpose of this case report is to highlight the potential malignancy of a solitary fibrous tumour of the lung along with the key features in diagnosis and management.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiothoracic Surgery, The Heart Hospital, University College London Hospitals (UCLH), London, UK.

ABSTRACT
Solitary fibrous tumours (SFTs) are rare neoplasms that in the majority of cases are benign. We present the case of a 52-year-old male, with a 23-year history of a slow growing pleural mass, presenting to our department with worsening dyspnoea and localised chest discomfort. The purpose of this case report is to highlight the potential malignancy of a solitary fibrous tumour of the lung along with the key features in diagnosis and management.

No MeSH data available.


Related in: MedlinePlus

The spindle cells show strong and diffuse positivity for Bcl-2. ×100 magnification.
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fig4: The spindle cells show strong and diffuse positivity for Bcl-2. ×100 magnification.

Mentions: A 52-year-old nonsmoking, male security worker presented with worsening dyspnoea and localised dull discomfort in the right midaxillary region between the 5th and 8th intercostal space. Routine blood tests were normal. Pulmonary function tests were normal. A computed tomography (CT) scan confirmed the presence of a solid mass measuring 14 × 7.5 × 9 cm occupying the fissure between the right middle and lower lobe (Figure 1). The mass increased in size by 75% compared with a CT scan performed a year earlier (Figure 2). The significant increase in tumour size and the onset of new symptoms led to a decision to resect the mass and establish a histological diagnosis. A right posterolateral thoracotomy was performed and a solid mass with a pedunculated attachment to the visceral pleura was found extending into the right middle and lower lobe fissure. The right lung was fully mobilised and the mass completely excised and sent for histological analysis (Figure 3). The mass was confirmed to be a solitary fibrous tumour of the pleura (SFTP) with the presence of spindle cells that tested positive for CD34, β-catenin, and Bcl-2 on subsequent immunohistochemistry assessment. Areas of hypercellularity, nuclear atypia, 18 mitoses per 10 high-power fields, and haemorrhagic and necrotic transformation were also identified, which confirmed that malignant transformation of a benign tumour had occurred (Figures 4, 5, and 6). The patient made an excellent postoperative recovery and was discharged home on day 4 after surgery. At 6 months' follow-up, the patient was clinically well and a repeat CT scan showed no evidence of recurrence.


The Potential Malignancy of a Solitary Fibrous Tumour of the Lung.

Shukla R, Patrini D, Borg E, Lawrence D, Hayward M, Panagiotopoulos N - Case Rep Pathol (2015)

The spindle cells show strong and diffuse positivity for Bcl-2. ×100 magnification.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4697093&req=5

fig4: The spindle cells show strong and diffuse positivity for Bcl-2. ×100 magnification.
Mentions: A 52-year-old nonsmoking, male security worker presented with worsening dyspnoea and localised dull discomfort in the right midaxillary region between the 5th and 8th intercostal space. Routine blood tests were normal. Pulmonary function tests were normal. A computed tomography (CT) scan confirmed the presence of a solid mass measuring 14 × 7.5 × 9 cm occupying the fissure between the right middle and lower lobe (Figure 1). The mass increased in size by 75% compared with a CT scan performed a year earlier (Figure 2). The significant increase in tumour size and the onset of new symptoms led to a decision to resect the mass and establish a histological diagnosis. A right posterolateral thoracotomy was performed and a solid mass with a pedunculated attachment to the visceral pleura was found extending into the right middle and lower lobe fissure. The right lung was fully mobilised and the mass completely excised and sent for histological analysis (Figure 3). The mass was confirmed to be a solitary fibrous tumour of the pleura (SFTP) with the presence of spindle cells that tested positive for CD34, β-catenin, and Bcl-2 on subsequent immunohistochemistry assessment. Areas of hypercellularity, nuclear atypia, 18 mitoses per 10 high-power fields, and haemorrhagic and necrotic transformation were also identified, which confirmed that malignant transformation of a benign tumour had occurred (Figures 4, 5, and 6). The patient made an excellent postoperative recovery and was discharged home on day 4 after surgery. At 6 months' follow-up, the patient was clinically well and a repeat CT scan showed no evidence of recurrence.

Bottom Line: Solitary fibrous tumours (SFTs) are rare neoplasms that in the majority of cases are benign.We present the case of a 52-year-old male, with a 23-year history of a slow growing pleural mass, presenting to our department with worsening dyspnoea and localised chest discomfort.The purpose of this case report is to highlight the potential malignancy of a solitary fibrous tumour of the lung along with the key features in diagnosis and management.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiothoracic Surgery, The Heart Hospital, University College London Hospitals (UCLH), London, UK.

ABSTRACT
Solitary fibrous tumours (SFTs) are rare neoplasms that in the majority of cases are benign. We present the case of a 52-year-old male, with a 23-year history of a slow growing pleural mass, presenting to our department with worsening dyspnoea and localised chest discomfort. The purpose of this case report is to highlight the potential malignancy of a solitary fibrous tumour of the lung along with the key features in diagnosis and management.

No MeSH data available.


Related in: MedlinePlus