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胸膜孤立性纤维瘤:13例分析

Solitary fibrous tumor of the pleura: an analysis of 13 cases.

作者信息

Lu Chunlai, Ji Yuan, Shan Fei, Guo Weigang, Ding Jianyong, Ge Di

机构信息

Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Fenglin Road 180, Shanghai 200032, China.

出版信息

World J Surg. 2008 Aug;32(8):1663-8. doi: 10.1007/s00268-008-9604-y.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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