Clinicopathological analysis of solitary fibrous tumor

Chinese-German Journal of Clinical OncologyMay 2012, Vol. 11, No.5, P282- -P284DOI 10.1007/s10330-011-0919-zClinicopathological analysis of solitary fibrous tumorXiumei Zhang, Hai Wang, Shujing W ang, Jinfeng Miao, Zhengai Piao, Yingying DongDepartment of Pathology, The Third People's Hospital of Dalian, Dalian 116033, ChinaReceived: 27 October 2011 1 Revised: 20 February 2012 1 Accepted: 5Apil 2012⑥Huazhong University of Science and Technology and Springer-Verlag Berlin Heidelberg 2012Abstract Objective: The aim of this study was to investigate the clinicopathologic characteristics, diagnosis and diferentialdiagnosis, molecular genetics, treatment and prognosis of solitary fibrous tumor (SFT). Methods: The clinicopathologicalmanifestations were analyzed retrospectively in 22 patients with surgically confirmed SFT. Results: There were 12 malepatients and 10 female patients, with the age range 33- 67 (mean 48.62) years. The SFTs originated from dfferent from partsof the body, including 13 in the chest, 2 in the lungs, 3 in the abdomen, 1 in the lumbosacral area, 2 in the pelvis, and 1 in theleft shoulder. There were 19 benign and 3 malignant tumors. Major clinical presentations were local masses and compressionsymptoms. Microscopy: the tumor was composed of areas of alternating hyerellularity and hyoellularity. The tumor cellswere spindle to short-spindle shaped and arranged in fascicular or storiform pattern and hemangiopericytoma-ike structurewas presented. Immunohistochemically, Vimentin positive rate was 100% (22), BcI-2 positive rate was 95.5% (2/22),CD99 positive rate was 86.4% (19/22), CD34 positive rate was 81.8 (18/22), focally positive for P53, as well as negative CK,S100 and Desmin. Ki67 labelling index was 2%- 30%. Conclusion: SFT is a rare tumor which may be found in various partsof human body. SFT mostly is a benign tumor, but a few could be malignant. Its diagnosis mainly rely on its morphologicfeatures and immunohistochemical profiles. The major treatment is to completely resect it by operation and long-term clinicalfllow-up is necessary.Key words solitary fibrous tumor (SFT); ciniopathology; diagnosis; dfrential diagnosisSolitary fibrous tumor (SFT) is rare mesenchymal neo- hydrated with graded ethanol. After washing with dis-plasm that has been considered as fusiform cell character- tilled water, the section was placed in the supplied buffer.istic. SFT was originally documented in pleura, recently For antigen retrieval, the slides were heated at 95 C forthe ubiquitous nature has been recognized with reported 40 min and then cooled for at least 20 min at room tem-of involvement of numerous sites all over the body. The perature. The sections were treated with 30 mL/L H2O2vast majority of SFTs are benign, but some cases have methanol at room temperature for 10 min to block en-been reported as malignant. Here, we presented 22 cases dogenous peroxidase and then washed with PBS for 5review of SFT and investigated features of clinicopathol- min. Individual slides were then incubated with primaryogy.antibody for 30 min at room temperature and Elivisionreagent for 30 min at room temperature. After extensiveMaterials and methodswashing with PBS, the color reaction was developed inDAB liquid system, according to the manufacture's in-Samplesstructions. The sections were then counterstained withTwenty- two cases were obtained from the Third Peo- Meyer's hematxylin. The results were observed underple's Hospital of Dalian, China, from June 2000 to Febru- light microscope.ary 2012. All the specimens were fixed in formalin andembedded with wax.ResultsImmunohistochemistryThere were 12 male patients and 10 female patients,Immunohistochemical staining of Vimentin, CD34，with the age range 33- 67 (mean 48.62) years. The SFTsCD99, Bcl-2, P53, Ki67, S100, Desmin and CK were done originated from different from parts of the body, includ-according to the manufacture's instructions. All of sec- ing 13 in the chest, 2 in the lungs, 3 in the abdomen, 1tions (4 pμm thick) were deparaffinized in xylene and de- in the lumbosacra中国煤化工1 in the leftshoulder. There wc N M H Gant tumors.Correspondence to: Xiumei Zhang. Email: xmzhang1215@hotmail.comMajor clinical pres比Jui sw and com-Chinese- German J Clin Oncol, May 2012, Vol. 11, No.5283Fig. 1 The lesion was composed of areas of alternating hyerellularity Fig. 4 Difusely positive for CD34 (HC staining x 100)and hyoellularity (HE staining x 100)Fig. 5 Difusely positive for CD99 (IHC staining x100)Fig. 2 Hemangiopericytomalike structure was presented (HE stainingx100)Fig. 6 Difusely positive for Bcl-2 (IHC staining x100)Fig. 3 The tumor cells showed marked nuclear atypia, increased mi-Immunohistochemically, Vimentin positive rate wastotic activity (HE staining x400)100% (222), CD34 positive rate was 81.8 (18/22; Fig.4), CD99 positive rate was 86.4% (19/22; Fig. 5), Bcl-2pression symptoms.positive rate was 95.5% (21/22; Fig. 6), focally positive forsured 2-20 cm. On the cut section, the excised specimensP53, as well as negative CK, S100 and Desmin. Ki67 label-were firm, grayish-white, or creamed white with whorledling index was 2%- 30%.and fasciculated surface and focal myxoid degeneration.DiscussionMicroscopically, the lesions were composed of areas ofalternating hypercellularity and hypocellularity (Fig. 1).Between them were separated by dense collagenous fi-。SFT is uncommon mesenchymal neoplasm. Most ofbrous stroma. In hypercellular areas, the tumor cells wereSFT is benign, but some cases have been reported as ma-spindle to short -spindle shaped and arranged in fascicularlignant. There has been considerable debate regardingor storiform pattern. In focal areas, hemangiopericytoma-its origin with various hypothesis. Recently due to vari-like structure was presented (Fig. 2). Three cases tumorous reports of its ubiquitous occurrence in almost everycells showed marked nuclear atypia, increased mitotic ac-site of the body, it is now believed to arise from dentritictivity (> 4/10 HPF; Fig. 3), coagulative necrosis and focalmesenchymal cell中国煤化Iericardium,ted in diversehemorrhage. Additionally, thick walled vessel hyaliniza-sites like pleura,tion was also observed.spinal cord, oral cMHC N M H Grbit, bulbarconjunctiva, upper respiratory tract, thyrold gland, car-