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PubMed2005

Cytopathology-histopathology of the mediastinum II. Mesenchymal, neural, and neuroendocrine neoplasms.

An appraisal of the cytopathology and corresponding histopathology of epithelial, germ cell, and lymphoid lesions of the mediastinum was previously reported in the Journal. This report aims to complete that topic with a discussion focusing on the correlative cyto-histopathology of the major mesenchymal, neural, and neuroendocrine neoplasms from this anatomic site. As previously stated, the mediastinum remains an uncommon site for fine needle aspiration (FNA) biopsy when compared with other anatomic sites. Yet, the recent use of endoscopic ultrasound-guided FNA for sampling mediastinal masses may increase this use. The purpose of this review is to focus on the shared and dissimilar morphologic features of this subset of neoplasms to improve diagnostic correlation between the two.

Humans↗
PubMedDate not supplied

The spectrum of pediatric fibroblastic and myofibroblastic tumors.

Fibroblastic and myofibroblastic tumors in neonates, infants, and children provide a diagnostic dilemma in surgical pathology due to their relative rarity and similarity in appearances. These tumors may be congenital or occur early during the first years of life or later during the first and second decades of life. The morphologic, immunocytochemical, ultrastructural, cytogenetic, and molecular features of the more "common" pediatric fibroblastic and myofibroblastic tumors are reviewed. In addition, the importance of a multimodal approach to tumor diagnosis is emphasized, with correlation with treatment and outcome differences among these unique fibroblastic and myofibroblastic tumors. The importance of providing an accurate diagnosis with pediatric fibroblastic and myofibroblastic tumors cannot be overstated, because treatment, prognosis, follow-up, and outcome are based on the initial assessment of these fascinating, but oftentimes, perplexing tumors.

Adolescent↗
PubMedDate not supplied

Synchronous solitary fibrous tumor of the pleura and lung cancer.

We report herein on a 57-year-old woman with comorbid malignant solitary fibrous tumor (SFT) of the pleura and adenocarcinoma of the lung. To the best of our knowledge, this is the first report of a patient presenting with these two pathological entities simultaneously. The patient was treated successfully for both diseases via a one-stage operation through median sternotomy with good results. Although the incidence of multiple primary malignancy is rare, clinicians should be cautious not to discount the possibility of two coexisting primary malignancies.

Adenocarcinoma↗
PubMed2003

[Bilateral renal solitary fibrous tumor].

OBJECTIVES: We report the first case of bilateral renal solitary fibrous tumor diagnosed in a patient suffering from tuberous sclerosis. METHODS: From the bibliographic review, only 15 cases of solitary fibrous tumor have been described in the kidney. We did not find any case of simultaneous bilateral involvement. We did not find any case described in a patient with tuberous sclerosis either, as the present case, being a 51-year-old female with presenting with a big abdominal mass arising from the left kidney (25 cm) and another 2 cm mass in the right kidney. CONCLUSIONS: We emphasize the extreme rarity of this tumor in the kidney. It has benign characteristics and behavior, and good prognosis, but requires surgical treatment to obtain a proper histopathologic diagnosis, based on immuno-histochemical studies.

Female↗
PubMed2001

Solitary fibrous tumor of the thyroid gland: report of seven cases.

Solitary fibrous tumor is a soft tissue neoplasm initially described in the pleura but subsequently reported in a wide variety of locations. The clinical behavior is usually benign, but the existence of aggressive cases has been documented both in the pleura and in extrapleural sites. In this report clinical and pathologic features of seven solitary fibrous tumors of the thyroid gland are presented. Patients' ages ranged from 43 to 64 years (mean 52 years), and tumor sizes varied from 2 to 6 cm. Grossly, the tumors were white-tan and well circumscribed. Microscopically, there was a variegated, wavy, storiform, hemangiopericytic or desmoid-like arrangement of spindle cells. Trapped thyroid follicles within the tumor and peripheral jagged tumor infiltration among follicles were common. There was immunohistochemical reactivity for CD34, CD99, and bcl-2, and ultrastructural analysis of one tumor was consistent with a fibroblastic lineage. The differential diagnosis included other benign and malignant mesenchymal tumors of the thyroid, spindle cell follicular adenoma, Riedel's thyroiditis, the spindle cell, and paucicellular variants of anaplastic carcinoma, papillary thyroid carcinoma with exuberant nodular fasciitis-like stroma, and the spindle epithelial tumor with thymus-like differentiation. The cumulative data of 13 cases (comprised of the seven present cases and the six previously reported) suggest a benign clinical behavior for thyroid SFT.

12E7 Antigen↗
PubMed2001

Telomerase activity, Ki-67, cyclin D1 and A expression, and apoptosis in solitary fibrous tumors: additional features of a predictable course?

Solitary fibrous tumors (SFTs) are infrequent soft tissue neoplasms which are usually benign and surgically curable. However, their behavior is not always predictable, although several clinical and pathological criteria of malignancy have been established. In many cancers, including some soft tissue tumors, telomerase activity (TA) has been shown to be a new reliable pathological marker of malignancy. Overexpression of some cyclins is associated with higher degrees of malignancy and predictive of the clinical course. In this study, we evaluated TA, mitotic and apoptotic indices (MI, AI), and the expression of Ki-67, cyclins D1 and A in five typical and two clinicopathologically atypical SFTs, the latter two of which had also recurred. High TA was demonstrated in the two atypical cases, which also showed a higher labeling index to Ki-67, as well as higher cyclin D1 and A expression, and either none or very few apoptoses. We suggest that TA, Ki-67, cyclin expression, and AI be evaluated in SFTs as possible adjunctive pathological criteria of behavior.

Adult↗
PubMedDate not supplied

[Pleura's solitary fibrous tumor. Clinical pathology analysis of 17 cases].

INTRODUCTION: Solitary fibrous tumor of the pleura (SFTP) is a rare neoplasm that usually originates from the visceral pleura, but it can occur in a wide range of tissues. Approximately 12% of pleural cases are malignant tumors and surgical excision usually become curative. The objective of this study is to present 17 new cases of SFTP and analyze the morphological characteristics that help to identify tumors with a malignant behavior. MATERIAL AND METHODS: We did a retrospective review of the patients who had primary pleural tumors from January 1995 to August 2005. RESULTS: Among a total of 94 primary pleural tumors, 17 patients were enrolled in this study, 8 men and 9 women, with a mean age of 63 years. Thirteen cases (76%) were benign and four cases (23%) were malignant. Local recurrences occurred in three cases. There were no metastases found. Recurrences occurred only in malignancy tumors. All malignant tumors were high cellularity and had hemiangiopericitic pattern, more than 4 mitoses per 10 high power fields, and moderate to marked polymorphism. CONCLUSIONS: SFTP shows a benign biologic outcome in most of the cases. There are some histological characteristics that led to distinguish between benign and malign neoplasm.

Adult↗
PubMed1998

Solitary fibrous tumour of the tongue.

Solitary fibrous tumour (SFT) is a neoplasm most often localised in the pleura and peritoneum. The tumour is composed of spindled fibroblastic cells arranged in a haphazard way. Recently SFT has been described in many locations. Only one case of oral SFT has been described in the cheek: this is the second case of an oral SFT located in the tongue. The differential diagnosis must be made from many soft tissue tumours. SFTs stain strongly, in almost all cases, for CD34.

Aged↗
PubMed1997

Solitary fibrous tumor of the skin.

Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm that most commonly involves the pleura, but is increasingly more often observed in extrapleural locations. A 37-year-old woman presented with an SFT involving the skin and subcutaneous tissue of the scalp. Histologically, SFT is well circumscribed and composed of uniform spindle cells arranged in interlacing fascicles. It exhibits alternating hypercellular and hypocellular areas with abundant thick, often keloid-like, hyalinized collagen. Hemangiopericytoma-like areas are frequently prominent. Immunohistochemical markers for smooth muscle, neural, and epithelial differentiation are negative, but generalized positivity for CD-34 is characteristic. Because of the expanding spectrum of anatomic involvement of SFT, it is not surprising that on rare occasions this tumor may involve the skin.

Actins↗
PubMed1997

Extrapleural solitary fibrous tumor: a report of seven cases.

Solitary fibrous tumors (SFTs) are rare, spindle-cell neoplasms generally associated with the serosal surface, especially the pleura. Histopathologic, immunohistochemical, ultrastructural, and flow cytometric analyses were performed on seven SFTs of extrapleural sites (two retroperitoneal, two soft tissue, one each peritoneal, nasal cavity, and orbit). Five patients were women, and two were men, aged from 21 to 68 years (average, 39 yr). All of the lesions presented as well-circumscribed masses. The lesions ranged in size from 2 to 20 cm in greatest diameter. Histologically, these lesions were entirely comparable to the pleural SFTs and lacked the characteristic features of other recognized neoplasms that occur in these regions. One tumor contained pleomorphic and round-cell sarcomatous foci. Immunohistochemically, all of the tumors were strongly positive for vimentin and CD34. Six of the seven tumors showed varying numbers of spindle cells positive for alpha smooth muscle actin, HHF35, neuron-specific enolase, Leu 7, or glial fibrillary acidic protein. Ultrastructural examinations of three tumors showed that they were composed of primitive mesenchymal or fibroblast-like cells. Six tumors examined were diploid by flow cytometric examination. Clinical follow-up in six patients ranged from 1 to 7.5 years (average, 2.6 yr) and showed that five patients remained well with no evidence of disease after excision and that the patient with the sarcomatous elements died of recurrence 2.5 years after surgical treatment. These findings suggest that SFTs represent ubiquitous neoplasms of fibroblasts or primitive mesenchymal cells with aggressive potential.

Adult↗
PubMed1997

Solitary fibrous tumour: clinicopathological, immunohistochemical, and ultrastructural analysis of 12 cases arising in soft tissues, nasal cavity and nasopharynx, urinary bladder and prostate.

The clinicopathological features of 12 extraserosal solitary fibrous tumours (SFT) are described. The age of the patients ranged from 18 to 72 years (mean: 48.2 years; median: 54 years); 5 were female patients. Seven lesions arose in soft tissue (5 in perifascial, and 1 each in subcutaneous and intramuscular tissues). They were situated in the groin (2 cases) and the neck, right buttock, left scapula, upper arm, and anterior abdominal wall (1 case each). One polypoid lesion was seen in in the nasal cavity and 1 in the nasopharynx; 2 neoplasms arose in the urinary bladder and 1 was located in the prostate and periprostatic tissue. Nine lesions were excised; in 1 patient wide excision was performed and in 2 patients, transurethral resection. Limited follow-up of 3 cases revealed a benign clinical course. The size of the neoplasms ranged from 1.7 cm to 20.0 cm (mean: 5.4 cm; median: 3.5 cm). Histologically, the neoplasms were well circumscribed and composed of cytologically bland spindle cells arranged without an obvious pattern; focally storiform or fascicular growth patterns were seen. Tumour cells were separated by thick bands of collagen demonstrating foci of keloid-like hyalinization. Prominent vascularity showing a haemangiopericytoma-like vascular pattern and vessels with thick, hyalinized vessel walls were seen in all cases. Increased mitotic activity was noted in 2 soft tissue cases (4-6 mitoses in 10 high-power fields); the other cases showed fewer than 2 mitotic figures in 10 highpower fields. Immunohistochemically, all cases tested stained positively for vimentin, CD34 and CD99, and 2 cases showed focal myofibroblastic differentiation. Two cases examined ultrastructurally showed a fibroblastic phenotype; focally pinocytic vesicles and microfilaments were identified. SFT represents a distinct neoplasm that should be included in the differential diagnosis of spindle-cell neoplasms in soft tissue, nasal cavity and nasopharynx, urinary bladder, and prostate. Strict diagnostic criteria are necessary to avoid overdiagnosis or confusion with more aggressive neoplasms in these locations.

Adolescent↗
PubMed2004

Primary lung carcinoma metastatic to a solitary fibrous tumor.

We report the case of a 78-year-old man with a 2 month history of newly diagnosed metastatic lung adenocarcinoma, who presented with a left gluteal soft tissue mass. Histological examination of the mass revealed a solitary fibrous tumor containing metastases from adenocarcinoma.

Adenocarcinoma↗