J Korean Soc Radiol.  2015 Feb;72(2):123-127. 10.3348/jksr.2015.72.2.123.

Calcifying Fibrous Tumor of the Pleura: A Rare Case with an Unusual Presentation on CT and MRI

• Lee D
• Haam SJ
• Choi SE
• Park CH
• Kim TH

• KMID: 2002808
• DOI: http://doi.org/10.3348/jksr.2015.72.2.123

Abstract

Calcifying fibrous tumors (CFTs) are rare benign mesenchymal tumors consisting of hyalinized collagenous fibrotic tissue with a lymphoplasmacytic infiltrate and dystrophic calcifications. Radiographic features have seldom been described, and there are no reports describing magnetic resonance imaging (MRI) findings. Here, we report a pleural CFT in a 47-year-old woman. The tumor mimicked an intrapulmonary lesion on initial computed tomography scans but migrated inferiorly and presented as an extra-pulmonary lesion on MRI. The tumor showed iso-signal intensity on T1-weighted images (WIs), low signal intensity on T2WIs, and slight rim enhancement on enhanced T1WIs.

MeSH Terms

Collagen
Female
Humans
Hyalin
Magnetic Resonance Imaging*
Middle Aged
Pleura*
Collagen

Figure

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  Fig. 1 Plain chest X-ray of the calcifying fibrous tumor of the pleura. Chest PA (A) and lateral view (B) show a 3 × 4.5 cm, oval-shaped, well-circumscribed mass-like lesion (arrow) in the left lower lung periphery.

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  Fig. 2 High-resolution CT image of the calcifying fibrous tumor of the pleura. Axial CT scan on mediastinal (A), lung window setting (B), and coronal view mediastinal setting (C) show a 2.5 × 4.5 cm well-circumscribed, lobulated mass (arrow) with coarse calcification, located above the diaphragm in the lingular segment of the left upper lobe.

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  Fig. 3 MR images of the calcifying fibrous tumor of the pleura. The ultrafast spine echo Half-Fourier-acquisition single-shot turbo spine-echo coronal image (A) shows an inferiorly migrated mass located in the extraparenchymal space between the left diaphragm and left lung. The mass (arrow) shows iso- to intermediate signal intensity on the T1-weighted image (B) and low signal intensity on the T2-weighted image (C). Slight peripheral rim enhancement was observed on the gadolinium-enhanced T1-weighted image (D).

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  Fig. 4 Gross images and histology of the specimen. The mass measured up to 6 cm, well demarcated, firm and lobulated (A). Cut surfaces of the mass revealed a solid, white, fibrous matrix without hemorrhage or necrosis (B). On microscopic exam, fibrotic tissue with dystrophic calcification was observed [hematoxylin and eosin stain (× 100)] (C) with vimentin positive on immunohistochemical staining (× 200) (D).

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