Watanabe Koichiro, Otsu Satoshi, Morinaga Ryotaro, Shirao Kuniaki
Department of Medical Oncology & Hematology, Oita University, Yufu-shi, Oita, Japan.
BMJ Case Rep. 2013 Jul 5;2013:bcr2013200126. doi: 10.1136/bcr-2013-200126.
A 75-year-old man presented to our hospital with multifocal thickening of the left pleura and left pleural effusion. Histology of the pleura showed uniform and bipolar spindle cells with moderate mitosis in a collagenised stroma. It further showed abundant blood vessels in a haemangiopericytoma-like pattern. These findings were strongly suggestive of malignant solitary fibrous tumour (SFT). The tumour showed negative staining for CD34. The loss of CD34 expression could imply histologically high-grade tumour, as reported previously. Imatinib, a multityrosine kinase inhibitor with targets, including platelet-derived growth factor receptor (PDGFR)-α and PDGFR-β, has antitumour activity in some patients with SFT. Unfortunately, imatinib treatment failed to control disease progression in the present case that expressed PDGFR-β, but not PDGFR-α. This report described a case of CD34-negative SFT resistant to imatinib.
一名75岁男性因左胸膜多灶性增厚及左侧胸腔积液入住我院。胸膜组织学检查显示,在胶原化基质中可见均匀的双极梭形细胞,有中度核分裂象。此外,肿瘤呈血管外皮细胞瘤样,血管丰富。这些表现强烈提示为恶性孤立性纤维性肿瘤(SFT)。肿瘤CD34染色阴性。如先前报道,CD34表达缺失可能意味着组织学上的高级别肿瘤。伊马替尼是一种多酪氨酸激酶抑制剂,其靶点包括血小板衍生生长因子受体(PDGFR)-α和PDGFR-β,对部分SFT患者具有抗肿瘤活性。遗憾的是,在本例表达PDGFR-β而不表达PDGFR-α的患者中,伊马替尼治疗未能控制疾病进展。本报告描述了一例对伊马替尼耐药的CD34阴性SFT病例。