右胸腔巨大孤立性纤维瘤1例及文献复习

Huge solitary fibrous tumor of the right thoracic cavity: a case report and literature review

目的探讨孤立性纤维瘤(solitary fibrous tumor,SFT)的临床与病理特征及诊断。方法应用HE染色及免疫组织化学染色观察并分析本院诊断的1例SET(女性患者,52岁,肿块位于右侧胸腔)临床病理特征及免疫组织化学表型,并复习相关文献。结果大体标本呈灰白灰红色,17 cm×14 cm×10 cm;镜下见部分区域细胞丰富,局灶轻度异型,未见明确核分裂像,无明显坏死;免疫组织化学表型:CD34、BCL2、STAT6阳性,TLE1部分阳性,Ki-67增值指数3%,CKpan、SMA、DES、S100、P63、MUC4阴性。结论孤立性纤维性肿瘤较为罕见,在形态学、免疫组织化学表型上具备一定的特殊性,但由于良性和转移性肿瘤在临床表现、影像学、组织病理学上均相似,故手术的完全切除和长期随访至关重要。

Objective To explore the clinical and pathological characteristics and diagnosis of solitary fibrous tumor(SFT)of thoracic cavity.Methods By applying HE staining and immunohistochemical staining,we observed and analyzed the clinical and pathological characteristics and immunohistochemical phenotype of a diagnosed case of SFT(female patient,52 years old,with the tumor located in the right thoracic cavity)in our hospital and reviewed related literature.Results The gross specimen appeared gray-white to gray-red,measuring 17 cm×14 cm×10 cm;microscopically,some areas were cell-rich with focal mild atypia,no definite mitotic figures were seen,and no significant necrosis was observed;immunohistochemical phenotype:CD34,BCL2,STAT6 positive,TLE1 partially positive,Ki-67 proliferation index 3%,CKpan,SMA,DES,S100,P63,MUC4 negative.Conclusion Solitary fibrous tumors are relatively rare and possess certain distinctiveness in morphology and immunohistochemical phenotype.However,due to the similarities in clinical presentation,imaging,and histopathology between benign and metastatic tumors,complete surgical excision and long-term follow-up are crucial.