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Mediastinum

Other benign / low grade tumors

Solitary fibrous tumor


Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 2 March 2013, last major update December 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Usually pleural, but also elsewhere and in mediastinum
● No association with asbestos
● Either no symptoms or symptoms of mass effect

Case reports
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● 18 year old man with 6 cm tumor (Gen Thorac Cardiovasc Surg 2010;58:205)
● 62 year old woman with stridor and a mass (Tumori 2007;93:508)
● En-bloc resection of malignant tumor (J Thorac Oncol 2008;3:1068)

Gross description
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● Firm, gray-white cut surface, well demarcated from adjacent tissue
● May resemble uterine leiomyoma
● Often polypoid protrusions from pleural reflections or derived from soft tissue between the lungs

Micro description
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● Bland spindle cells arranged haphazardly in fibrohyaline stroma resembling keloid
● Abundant thick walled blood vessels, often with staghorn appearance
● May have mesothelial lining
● Usually few mitotic figures but may have up to 10 per 10 HPF
● Occasional myxohyaline degeneration, storiform growth, nuclear pleomorphism, marked cellularity; no necrosis

Positive stains
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● CD34, vimentin

Negative stains
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● Actin, desmin, EMA, keratin, S100

Electron microscopy description
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● Nondescript spindle cells with prominent rough endoplasmic reticulum, focal intrareticular collagen fibers
● No features of myofibroblasts, smooth or skeletal muscle, epithelial differentiation

End of Mediastinum > Other benign / low grade tumors > Solitary fibrous tumor


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