Cleveland Clinic, Cleveland, Ohio, USA.
Diagn Cytopathol. 2020 Dec;48(12):E27-E32. doi: 10.1002/dc.24544. Epub 2020 Jul 6.
Solitary fibrous tumor (SFT) is a mesenchymal tumor initially described in the pleura. When the tumor is located in the pleura and the classic histologic findings are present, the diagnosis of SFT can be straightforward. However, the cytologic diagnosis of perigastric SFT can be challenging due its rarity with only one cytology case report. Another confounding factor is its potential mimicry with other perigastric/gastric mesenchymal tumors. Herein, we report a case of perigastric SFT diagnosed on cytology in conjunction with immunohistochemical stains. The patient is a 79-year-old woman who presented with an enlarging perigastric mass on computerized tomography scan which was highly concerning for a saccular aneurysm. Endoscopic ultrasound (EUS) revealed a 6.6 cm hypoechoic lesion abutting the stomach. An EUS-guided fine needle aspiration was performed. The smears showed singly scattered to clusters of bland spindle cells with scant cytoplasm dispersed in a bloody background. The cell block showed similar spindle cells focally supported by a collagenized stroma. Immunohistochemical stains performed on the cell block showed the tumor cells were positive for CD34, BCL2, and STAT6 and negative for CD117, DOG1, CD31, ERG-ENDO, AE1/AE3, S-100, desmin, and synaptophysin, supporting the diagnosis of solitary fibrous tumor.
孤立性纤维瘤(SFT)是一种最初在胸膜中描述的间叶性肿瘤。当肿瘤位于胸膜且具有经典的组织学表现时,SFT 的诊断通常较为直接。然而,由于胃周 SFT 较为罕见,仅有一例细胞学病例报告,因此其细胞学诊断具有挑战性。另一个混淆因素是其可能与其他胃周/胃间质性肿瘤相混淆。本文报告了一例经细胞学结合免疫组织化学染色诊断的胃周 SFT 病例。患者为 79 岁女性,因计算机断层扫描显示胃周肿块增大而就诊,高度怀疑为囊状动脉瘤。内镜超声(EUS)显示一个 6.6 厘米的低回声病变紧贴胃。进行了 EUS 引导下的细针抽吸。涂片显示单个散在或簇状的温和梭形细胞,细胞浆稀少,散布在血性背景中。细胞块显示类似的梭形细胞,局部由胶原化基质支撑。细胞块上进行的免疫组织化学染色显示肿瘤细胞 CD34、BCL2 和 STAT6 阳性,CD117、DOG1、CD31、ERG-ENDO、AE1/AE3、S-100、结蛋白和突触素阴性,支持孤立性纤维瘤的诊断。