Korean J Radiol.  2013 Dec;14(6):981-984. 10.3348/kjr.2013.14.6.981.

Solitary Fibrous Tumor of the Pleura Manifesting as an Air-Containing Cystic Mass: Radiologic and Histopathologic Correlation

• Baek JE
• Ahn MI
• Lee KY

• KMID: 1711468
• DOI: http://doi.org/10.3348/kjr.2013.14.6.981

Abstract

Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm that typically presents as a well-defined lobular soft tissue mass commonly arising from the pleura. We report an extremely rare case of an SFT containing air arising from the right major fissure in a 58-year-old woman. Chest CT showed an ovoid air-containing cystic mass with an internal, homogeneously enhancing solid nodule. To our knowledge, this is the first case in the literature. The histopathologic findings were correlated with the radiologic findings, and the mechanism of air retention within the tumor is discussed.

Keyword

Solitary fibrous tumor of the pleura; Air-containing mass; CT; Histopathology

MeSH Terms

Cysts/*diagnosis
Diagnosis, Differential
Female
Follow-Up Studies
Humans
Middle Aged
Pleura/*pathology/radiography/radionuclide imaging
Positron-Emission Tomography/*methods
Solitary Fibrous Tumor, Pleural/*diagnosis/surgery
Thoracic Surgery, Video-Assisted
Tomography, X-Ray Computed/*methods

Figure

• 

  Fig. 1 Solitary fibrous tumor of pleura containing air in 58-year-old woman. A. Chest radiograph on admission shows air-containing cystic mass in right upper lung field. B-E. Chest CT images demonstrate 4.5 cm ovoid or spindle-shaped cystic mass along upper portion of right major fissure, which contains eccentrically located soft tissue nodule surrounded by large amount of air (B, C). Mass has irregular thin wall. Internal soft tissue nodule enhanced relatively homogeneously after contrast injection (D, E). F. Chest CT image obtained two years prior to current presentation reveals same-sized cystic mass, with much smaller internal solid nodule compared to recent CT images (B), suggesting nodule growth. G, H. F18-fluorodeoxyglucose (FDG) PET/CT scans of soft tissue nodule show mild FDG uptake with SUVmax of 2.3. I. Intraoperative photograph shows well-encapsulated pedunculated pleural tumor (arrow) arising from visceral pleura of right major fissure covering right upper lobe. J. Photograph of cut sections of resected specimen reveals well-encapsulated air-containing cystic mass with eccentrically located yellow-gray-colored solid nodule. K-N. Photomicrographs of specimen demonstrate variable components of spindle-shaped tumor cells and collagen fibers arranged in haphazard pattern, consistent with SFT in both internal nodular (K) and cystic (L) portions of tumor (hematoxylin-eosin stain, × 200). Cystic spaces are lined by cuboidal cells (arrows, L). Stains for TTF1 (M) and CK7 (N) show immunoreactivity in cystic lining epithelium, suggesting that they were pneumocytes.

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