Solitary fibrous tumor

Pleura & peritoneum

Pleura other tumors

Topic Completed: 1 December 2013

Minor changes: 11 January 2021

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PubMed Search: Solitary fibrous tumor[TI] pleura[TI] full text[sb]

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Cite this page: Pernick N. Solitary fibrous tumor. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/pleurasolitaryfibrous.html. Accessed January 22nd, 2021.

Definition / general

Also called localized fibrous tumor
Formerly called benign or solitary fibrous mesothelioma
Confined to surface of lung, usually does not produce a pleural effusion
Associated with pulmonary osteoarthropathy, digital clubbing and hypoglycemia, which regress after tumor resection
Most likely fibroblastic and not mesothelial in origin, arising from submesothelial mesenchyme
Not associated with asbestos
May recur locally
May cause death due to extensive intrathoracic growth or if malignant
Malignant cases are very rare

Case reports

66 year old man with pleural tumor exhibiting liposarcomatous differentiation (Arch Pathol Lab Med 2001;125:406)
85 year old woman with 6 cm pleural mass (Case #358)

Treatment

Surgical excision

Gross description

Arises from pleural surface by a pedicle
Solitary, well circumscribed, may be encapsulated
Composed of dense, gray-white fibrous tissue with firm, whorled cut surface (like uterine leiomyoma), large tumors may be cystic and hemorrhagic

Gross images

Images hosted on other servers:

Smooth rounded mass

Microscopic (histologic) description

Fibroblast-like cells with variable cellularity in collagenous, keloid-like stroma, reticulin fibers, hemangiopericytoma-like vessels
No / rare mitotic activity, no atypia
May entrap mesothelium or epithelium at periphery
May have focal or marked myxoid change with bland spindle cells in myxoid, vascularized stroma (Mod Pathol 1999;12:463)
Malignant cases show increased cellularity, marked nuclear atypia, prominent necrosis, high mitotic activity

Microscopic (histologic) images

Case #358