Question:

Which of the following are correct in regards to SFTP?
1. SFTP may be associated with paraneoplastic phenomena.
2. CT should demonstrate an irregular, pleural based mass with invasion into the surrounding soft tissues and bone.
3. Malignant potential of SFTP always correlates with histologic findings.
4. Microscopically, SFTP demonstrates a "patternless" architecture with rare mitotic figures.
5. Immunohistochemistry plays an important role in the diagnosis of SFTP, and should correlate with positive CD34 staining.





Answer:

The correct answers for the question "Which of the following are correct in regards to SFTP?" are:

1. SFTP may be associated with paraneoplastic phenomena.

4. Microscopically, SFTP demonstrates a "patternless" architecture with rare mitotic figures.

5. Immunohistochemistry plays an important role in the diagnosis of SFTP, and should correlate with positive CD34 staining.



Explanation

a. SFTP may be associated with paraneoplastic phenomena. (Digital clubbing and hypertrophic pulmonary osteoarthropathy (collectively referred to as Pierre-Marie-Bamberg syndrome) and refractory hypoglycemia (Doege-Potter syndrome) have been reported to occur in ten to twenty percent and five percent of patients, respectively [5,6].)

b. CT should demonstrate an irregular, pleural based mass with invasion into the surrounding soft tissues and bone. (Computed tomography (CT) usually demonstrates a smoothly marginated, pleural based soft tissue mass with either uniform soft tissue attenuation or inhomogeneous enhancement secondary to myxoid degeneration, hemorrhage or necrosis.)

c. Malignant potential of SFTP always correlates with histologic findings. (Unfortunately, malignant potential may not always correlate with histologic findings, and some cases of SFTP may progress to the malignant type of disease [11].)

d. Microscopically, SFTP demonstrates a "patternless" architecture with rare mitotic figures. (Microscopically, SFTP demonstrates a "patternless" architecture consisting of alternating hypocellular and hypercellular areas separated by bands of hyalinized collagen and vessels resembling those of hemangiopericytoma.)

e. Immunohistochemistry plays an important role in the diagnosis of SFTP, and should correlate with positive CD34 staining. (Immunohistochemistry is essential in differentiating SFTP from mesotheliomas and other etiologies… Furthermore, in contrast to mesotheliomas and other sarcomatous lesions, confirmation of SFTP should be gained from specific immunohistochemical stains, including CD34 (90-95%) and CD99 (70%) positivity, regardless of benign or malignant nature.)



From the manuscript:
Solitary fibrous tumor of pleura: a case report and review of clinical, radiographic and histologic findings
Radiology Case. 2009 May; 3(5):16-20


This article belongs to the Chest section.




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From the manuscript

Solitary fibrous tumor of pleura: a case report and review of clinical, radiographic and histologic findings

Free full text article: Solitary fibrous tumor of pleura: a case report and review of clinical, radiographic and histologic findings

Abstract
We present a case of solitary fibrous tumor of pleura (SFTP) in a 63-year-old male. Clinical manifestations of this entity, including paraneoplastic syndromes, are discussed, albeit absent in our presented case. Furthermore radiographic findings and pathologic correlations are provided. SFTP remains a rare neoplasm for which radiographic features are suggestive yet nonspecific, and immunohistochemistry remains as the diagnostic method of choice.






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