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[胸膜巨大孤立性纤维瘤:一例报告及文献复习]

[Giant solitary fibrous tumor of the pleura: A case report and literature review].

作者信息

Xu Guangyan, Zhang Jianyong

机构信息

Department of Respiratory Disease, Affiliated Hospital, Zunyi Medical College, Zunyi Guizhou 563003, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2016 Oct 28;41(10):1111-1116. doi: 10.11817/j.issn.1672-7347.2016.10.017.

Abstract

Solitary fibrous tumor (SFT) is a derived mesenchymal tumor from spindle cells, mostly occurred in the pleura. To analyze the clinical features of the SFT, data for a patient with SFT that involved in the pleura were retrospectively analyzed by assisted thoracoscope in the Affiliated Hospital of Zunyi Medical College in August 2015. The male patient was 45 years old, who showed the main clinical symptoms of chest pain, cough, sputum, and dyspnea. Large amount of right pleural effusion, chest space-occupying lesions were found by chest CT, suggesting a malignant tumor with metastasis at the 2nd and 3rd right rib. Immunohistochemical results showed: CD34 (+), cytokeratin (-), cytokeratin 5/6 (-), calretinin (-), epithelial membrane antigen(-), mesothelial cell (-), vimentin (++), Wilm's tumor-1 (+), Bcl-2 (+), CD56 (-), CD99 (+), desmin (-), and thyroid transcription factor-1 (-). It was diagnosed as SFT at right side wall layer pleura. SFT is a rare disease and it may occur at any site in the body. It lacks characteristic clinical symptoms and can be asymptomatic, or displays symptoms such as cough, chest pain, dyspnea, and hemoptysis. SFTs can only be conclusively diagnosed based on histopathologic and immunohistochemical characteristics of the tumor, and they are mostly benign. The main treatment for SFTs is the complete surgical resection. The prognosis for this disease is relatively good.

摘要

孤立性纤维瘤(SFT)是一种起源于梭形细胞的间叶组织肿瘤,多发生于胸膜。为分析SFT的临床特征,对2015年8月在遵义医学院附属医院经胸腔镜辅助诊治的1例累及胸膜的SFT患者资料进行回顾性分析。该男性患者45岁,主要临床症状为胸痛、咳嗽、咳痰及呼吸困难。胸部CT检查发现右侧大量胸腔积液及胸部占位性病变,提示为恶性肿瘤伴右侧第2、3肋骨转移。免疫组化结果显示:CD34(+)、细胞角蛋白(-)、细胞角蛋白5/6(-)、钙视网膜蛋白(-)、上皮膜抗原(-)、间皮细胞(-)、波形蛋白(++)、肾母细胞瘤蛋白-1(+)、Bcl-2(+)、CD56(-)、CD99(+)、结蛋白(-)、甲状腺转录因子-1(-)。诊断为右侧壁层胸膜SFT。SFT是一种罕见病,可发生于身体任何部位。它缺乏特征性临床症状,可无症状,或表现为咳嗽、胸痛、呼吸困难及咯血等症状。SFT只能根据肿瘤的组织病理学和免疫组化特征确诊,且大多为良性。SFT的主要治疗方法是完整手术切除。该病预后相对较好。

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