Solitary Fibrous Tumor of the Pleura: Report of a Case

肋膜單一纖維瘤是一種罕見、生長緩慢的腫瘤，一般認為源自間質。大體上，大部分的肋膜單一纖維瘤從臟層肋膜長出，並以肉莖的方式與之相連。顯微鏡下，該腫瘤由梭狀、似纖維母細胞的細胞與結締組織以一種無形態的方式緊密交織在一起。在免疫組織化學上，該腫瘤對vimentin呈陽性反應，對keratin則呈陰性反應。大多數的肋膜單一纖維瘤也會有CD34，bcl-2，以及CD99的表現。本篇報告提出一位罹患巨大(18×15×8cm)肋膜單一纖維瘤的83歲男性。臨床症狀包括持續一週以上的飽脹感及間歇性發燒。腹部超音波顯示，右側橫隔上方有一巨大而且呈現高度回音性的病灶。胸部X光顯示右下肺野不透明。對比強化後的電腦斷層掃瞄顯示，右側胸腔內有一輪廓明確、異質性的腫塊對右下肺葉造成壓迫性塌陷，並對肝臟形成推擠。超音波導引穿刺針切片檢查證實，該腫瘤的主要組成要素為梭狀細胞。手術完全切除後，病理及免疫組織化學分析證明為肋膜單一纖維瘤。病人術後復原順利，現於門診追蹤已一年，未發現復發。

關鍵字

無資料

並列摘要

Solitary fibrous tumors of the pleura (SFTPs) are rare, slow-growing neoplasms that are widely recognized as mesenchymal in origin. Grossly, most SFTP arise from the visceral pleura in a pedunculated manner. Microscopically, they consist of spindle fibroblast-like cells intimately intertwined with connective tissue in a disorderly pattern. Immunohistochemically, the tumors are vimentin-positive and keratin-negative. The expression of CD34, bcl-2, and CD99 can also be seen in most of them. We report a giant (18×15×8cm) SFTP in an 83-year-old man presenting with the feeling of abdominal fullness and intermittent fever for more than 1 week. Abdominal sonography showed a huge hyperechoic lesion above the right diaphragm. A chest radiograph revealed opacity in the right lower lung field. A well-defined heterogeneous mass in the right thorax, causing atelectasis of the right lower lobe and displacement of the liver, was found on the contrast-enhanced computed tomography of the chest. An ultrasound-guided needle biopsy demonstrated that spindle cells were the dominant component of the neoplasm. Curative resection was performed and the histologic and immunohistochemical studies confirmed an SFTP. The postoperative recovery was uneventful and the patient has remained well on outpatient follow-up.

並列關鍵字

solitary fibrous tumor ； pleura

國際替代計量

Solitary Fibrous Tumor of the Pleura: Report of a Case

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