Liver and intrahepatic bile ducts - Solitary fibrous tumor

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Liver and intrahepatic bile ducts - Tumor

Benign tumors

Solitary fibrous tumor

Reviewers: Deepali Jain, M.D. (see Reviewers page)
Revised: 9 January 2013, last major update February 2012
Copyright: (c) 2004-2013, PathologyOutlines.com, Inc.

General
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● Also called localized fibrous tumor/localized fibrous mesothelioma
● Rare; fewer than 40 reported cases in liver; may arise from beneath liver capsule
● Predominantly occur in women (2:1); age range 27-83 years
● Associated with hypoglycemia

Case reports
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● 66 year old Italian man (Arch Pathol Lab Med 2003;127:e255)

Treatment
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● Complete surgical resection with long term follow up

Gross description
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● Solitary mass, well circumscribed, encapsulated, often 15 cm or more, with bulging, solid, gray-white cut surface, highly vascular

Micro description
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● Patternless architecture, alternating hypocellular and hypercellular areas
● Spindle cells without atypia mixed with hyalinized collagen
● Mild atypia; rare mitotic figures; no necrosis
● Criteria for malignancy: high cellularity and mitotic activity (>4/10hpf), pleomorphism, necrosis, and local invasion

Gross/micro images
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H&E and CD34

Positive stains
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● CD34, BCL2, vimentin, CD99

Negative stains
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● Cytokeratin, EMA, CD117, S100, smooth muscle actin, desmin, chromogranin, synaptophysin

Differential diagnosis
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● Inflammatory pseudotumor: plasma cells, obliterative phlebitis, SMA+, CK+
● Leiomyoma: SMA+
● Sclerosed hemangioma: CD34 in endothelial cells only, elastic fibers around vessels

End of Liver and intrahepatic bile ducts - Tumor > Benign tumors > Solitary fibrous tumor

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