Solitary fibrous tumor
Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 8 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.
See also Kidney tumor-benign chapter for more images
● Tumor with markedly collagenous stroma and irregularly distributed thick walled vessels; common at many sites; may be intrapulmonary and not pleural
● Peaks at ages 50-69 years
● Larger tumors (> 7 cm) associated with hypoglycemia, pleural effusion, pulmonary osteoarthropathy
● Even bland tumors may have aggressive behavior
● Firm, rounded, lobulated
● Variable cysts, hemorrhage, necrosis
● Markedly collagenous stroma (ropey collagen) with irregularly distributed thick walled vessels and cellular bland spindle cells
● May have myxoid stroma
● Low grade: <5 mitoses per 10 HPF with bland spindle cells, no atypia
● Often has malignant features (pleomorphism, tumor giant cells, mitotic figures)
● Patterns: adenofibroma (Int J Surg Pathol 2005;13:79), fibrosarcoma, hemangiopericytoma, MFH-like, neural
Benign and malignant tumors
● CD34, CD99, BCL2 (Am J Surg Pathol 2012 Oct 26 [Epub ahead of print])
● Vimentin, nuclear and cytoplasmic beta catenin (Arch Pathol Lab Med 2006;130:1503)
● p53 expression related to prognosis (Am J Surg Pathol 2008;32:1627)
● D2-40 (usually, Appl Immunohistochem Mol Morphol 2010;18:411), smooth muscle actin
End of Lung tumor > Benign tumors > Solitary fibrous tumor
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