Cytopathological features of solitary fibrous tumor of the pleura: a study of 5 cases

Our plain-English summary of Cytopathological features of solitary fibrous tumor of the pleura: a study of 5 cases, by B. Weynand, P. Collard, C. Galant (Diagnostic Cytopathology, 1998).

The study

• Authors: B. Weynand, P. Collard, C. Galant
• Journal: Diagnostic Cytopathology
• Published: 1998;18(2):118-24
• Type of article: Case report
• Cited by: 19 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Solitary fibrous tumor is a rare lesion of serosal membranes. In a pleural location, it may be confused clinically with a localized mesothelioma or a peripheral lung tumor. A transthoracic needle aspiration can be done to obtain material for a diagnosis in these easily accessible tumors. In the literature, there are only sporadic reports of cytology of solitary fibrous tumor in pleural fluid or in material obtained by percutaneous fine-needle aspiration. We had the opportunity to study five such cases by cytology and biopsy and in four cases we could study the resected specimen as well. We want to emphasize the possibilities of approaching diagnosis by cytologic material. A more precise diagnosis can be made if immunohistochemistry can be applied on a cell block or a concomitant biopsy specimen. We shall discuss the differential diagnosis of these tumors on cytologic material and/or biopsy and the usefulness of the CD34 antibody.

In plain English

This was a case series of five patients with solitary fibrous tumor of the pleura, a rare tumor of the lining of the chest. The patients were four men and one woman aged 59 to 69. The authors worked at a Brussels university hospital. The article did not discuss asbestos. All five patients had a needle aspiration and a needle core biopsy, and four later had surgery. On the aspiration smears, all cases were read as a mesenchymal tumor without significant atypia. Surgery confirmed the diagnosis in all four removed tumors, which measured 8.5 to 19 cm across. One of these was judged a borderline tumor. All tumors stained positive for vimentin and negative for cytokeratin. CD34 was positive in all formalin-fixed tissue but negative in tissue fixed in Bouin's fluid. During 6 months to 5 years of follow-up there was no recurrence or death, and the one tumor that was not removed was still slowly growing. The authors concluded that these tumors can be diagnosed from needle aspiration material, especially when immunostaining can be done on a cell block or biopsy.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case series (five cases) studied by fine-needle aspiration cytology, needle core biopsy and, in four cases, the surgically removed tumor
• Who was studied: five patients (four men, one woman, aged 59 to 69, mean 64) with solitary fibrous tumor of the pleura; the authors were at Saint Luc University Hospital, Brussels, Belgium; study dates not given
• Exposure: The article does not report or discuss asbestos or any other exposure; it is a study of diagnostic methods
• Main results:
  • In four patients the tumor was found incidentally on a routine chest X-ray; the fifth had digital clubbing, which led to lung investigations
  • On cytology, all five cases were diagnosed as a mesenchymal tumor without significant atypia; for two patients a possible nerve sheath origin was proposed
  • The four resected tumors measured 8.5 to 19 cm in diameter and weighed 144 to 1,550 g; all were attached to the visceral pleura
  • Diagnosis was confirmed in all resected tumors; one patient's tumor showed focally more than 4 mitoses per 10 high power fields and was considered a borderline tumor needing close follow-up
  • All tumors expressed vimentin and were negative for cytokeratin; CD34 was widely expressed in all formalin-fixed tissues but negative in Bouin-fixed fragments
  • Two cases showed focal muscle specific actin; desmin and 68 kd neurofilament were negative
  • Follow-up ranged from 6 months to 5 years without recurrence or fatal outcome; the one non-resected tumor was still slowly progressing without signs of aggressiveness
• The authors' conclusion: The authors concluded that localized fibrous tumors can be diagnosed from material obtained by transthoracic needle aspiration, especially when immunohisto(cyto)chemistry can be done on a cell block or biopsy specimen, and that a precise diagnosis allows lung-sparing surgery
• Limitations the authors state:
  • The authors state that a precise diagnosis by cytology alone may be difficult, especially in predominantly fibrous and hypocellular lesions

Topics

Medical terms in this study, explained in our Lexicon: Solitary Fibrous Tumor, Localized Malignant Mesothelioma, Cytology, Fine-Needle Aspiration, Biopsy, Immunohistochemistry, Cell Block, Differential Diagnosis.

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• Solitary fibrous tumor of the liver: a clinicopathologic and immunohistochemical study of nine cases — C.A. Moran, K.G. Ishak, et al. (1998)
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• Localized fibrous tumors (LFTs) of the pleura: clinical data, asbestos burden, and syntactic structure analysis applied to newly defined angiogenic/growth-regulatory effectors — K. Kayser, J. Trott, et al. (2005)
• Solitary fibrous tumour of the tongue: a case report with immunohistochemical studies — Y. Yamashita, T. Satoh, et al. (2002)

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