Lu Chunlai, Ji Yuan, Shan Fei, Guo Weigang, Ding Jianyong, Ge Di
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Fenglin Road 180, Shanghai 200032, China.
World J Surg. 2008 Aug;32(8):1663-8. doi: 10.1007/s00268-008-9604-y.
Solitary fibrous tumor of the pleura is a rare soft-tissue tumor. In search of appropriate diagnosis and treatment methods, we present our experience with 13 patients.
The medical charts of 13 patients treated during the last 5 years were reviewed, as well as pathological records, including immunohistochemical stains. Follow-up data were obtained. In addition, a literature review with regard to treatment and clinical outcome was performed.
Our series consisted of four men and nine women with a mean age of 47 years. Two were diagnosed before operation with ultrasonography-guided core needle biopsy. All patients underwent primary surgical treatment, and four of them were resected by video-assisted thoracic surgery. Seven tumors were malignant and the other six were benign. Immunohistochemical staining showed nestin was positive in three malignant solitary fibrous tumors of pleura (3/7), which were negative for CD34. Except for one, all patients were followed-up for 3 to 35 (mean, 14.5) months. Among them, one patient experienced a recurrence and one patient died of brain metastasis.
Ultrasonography-guided core needle biopsy combined with immunohistochemical analysis might be a safe and rapid method to provide a confirmatory diagnosis before resection. For smaller, pedunculated tumors, video-assisted thoracic surgery could be a powerful and useful approach. We speculate that CD34-negative and nestin-positive might be a malignant marker for solitary fibrous tumor of pleura.
胸膜孤立性纤维瘤是一种罕见的软组织肿瘤。为寻找合适的诊断和治疗方法,我们介绍13例患者的经验。
回顾过去5年中治疗的13例患者的病历以及病理记录,包括免疫组化染色。获取随访数据。此外,对治疗和临床结果进行了文献综述。
我们的病例系列包括4名男性和9名女性,平均年龄47岁。2例术前经超声引导下粗针穿刺活检确诊。所有患者均接受了一期手术治疗,其中4例通过电视胸腔镜手术切除。7例肿瘤为恶性,其余6例为良性。免疫组化染色显示,3例恶性胸膜孤立性纤维瘤(3/7)巢蛋白呈阳性,CD34呈阴性。除1例患者外,所有患者均随访3至35个月(平均14.5个月)。其中,1例患者复发,1例患者死于脑转移。
超声引导下粗针穿刺活检联合免疫组化分析可能是一种安全、快速的方法,可在切除前提供确诊诊断。对于较小的带蒂肿瘤,电视胸腔镜手术可能是一种有效且有用的方法。我们推测,CD34阴性且巢蛋白阳性可能是胸膜孤立性纤维瘤的恶性标志物。