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Park, Kwak, Park, Koo, Kim, Park, Ahn, Kim, Kim, Sohn, Chung, Yoon, Shin, and Park: A Case of a Solitary Fibrous Tumor of the Pleura Presenting as Pneumonia and Acute Respiratory Failure
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(4): 334-338.

Published online: 31 October 2008

DOI: https://doi.org/10.4046/trd.2008.65.4.334

A Case of a Solitary Fibrous Tumor of the Pleura Presenting as Pneumonia and Acute Respiratory Failure

Hye Sun Park, M.D.1, Hyun Jung Kwak, M.D.1, Dong Won Park, M.D.1, Tai Yeon Koo, M.D.1, Hye Young Kim, M.D.1, So Yeon Park, M.D.1, Seong Eun Ahn, M.D.1, Sang-Heon Kim, M.D.1, Tae Hyung Kim, M.D.1, Jang Won Sohn, M.D.1, Won Sang Chung, M.D.2, Ho Joo Yoon, M.D.1, Dong Ho Shin, M.D.1, Sung Soo Park, M.D.1

1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

2Department of Thoracic and Cardiovascular Surgery, Hanyang University College of Medicine, Seoul, Korea.

Address for correspondence: Sung Soo Park, M.D. Department of Internal Medicine, Hanyang University College of Medicine, 17, Haengdang-dong, Seongdong-gu, Seoul 133-792, Korea. Phone: 82-2-2290-8347, Fax: 82-2-2298-9183, sspark@hanyang.ac.kr

Received 22 July 2008       Accepted 31 July 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Solitary fibrous tumors of the pleura (SFTPs) are relatively rare tumors that originate from the mesenchymal cells of the submesothelial tissue of the pleura. Patients with SFTPs are often asymptomatic, while some patients experience pleuritic chest pain, cough and/or dyspnea. We report here on a case of SFTP, and the patient presented with septic shock and respiratory failure that required mechanical ventilation. A 68-year-old woman was admitted for the evaluation of her dyspnea and generalized edema. Chest imaging studies showed an 18 cm-sized voluminous mass occupying the right thoracic cavity with anterior displacement of hilar structures and atelectasis of the right lung. Immediately after admission, she developed pneumonia and septic shock that required antibiotics and mechanical ventilation. She displayed a partial response to medical treatment, and then complete excision of the tumor was performed and the pathologic examination revealed benign SFTP. Afterward, she fully improved without evidence of recurrence until now.

Keywords: solitary fibrous tumor of pleura, respiratory failure, generalized edema

Figures and Tables

Figure 1
(A) Chest radiograph on admission shows mass shadows occupying middle and lower zone of right hemithorax. (B) Chest CT on admission shows a well-defined homogenous mass in the right thoracic cavity with partial atelectasis (black arrow) and anterior displacement of hilar structures (white arrow).
trd-65-334-g001
Figure 2
Gross appearance of the tumor. The cut section shows a well circumscribed encapsulate white mass, measuring 18×13×5 cm.
trd-65-334-g002
Figure 3
(A) The tumor is composed of short spindle cells with abundant stromal collagen bundles and ectactic vessels (H&E stain, ×200). (B) The tumor cells are diffuse strong positive for CD34 staining (×200).
trd-65-334-g003

Notes

This study was supported by a grant from the Korea Health 21 R&D Project, Ministry of Health & Welfare, Korea (Grant No. 0412-CR03-0704-0001).

References

1. Klemperer P, Coleman BR. Primary neoplasms of the pleura: a report of five cases. Am J Ind Med. 1992. 22:1–31.
2. de Perrot M, Fischer S, Brundler MA, Sekine Y, Keshavjee S. Solitary fibrous tumors of the pleura. Ann Thorac Surg. 2002. 74:285–293.
3. Okike N, Bernatz PE, Woolner LB. Localized mesothelioma of the pleura: benign and malignant variants. J Thorac Cardiovasc Surg. 1978. 75:363–372.
4. Briselli M, Mark EJ, Dickersin GR. Solitary fibrous tumors of the pleura: eight new cases and review of 360 cases in the literature. Cancer. 1981. 47:2678–2689.
5. Sung SH, Chang JW, Kim J, Lee KS, Han J, Park SI. Solitary fibrous tumors of the pleura: surgical outcome and clinical course. Ann Thorac Surg. 2005. 79:303–307.
6. Torre W, Rodriguez-Spiteri N, Sola JJ, Delgado M. Localized fibrous tumors of the pleura: experience with 7 recent cases. Arch Bronconeumol. 2004. 40:329–332.
7. Shaker W, Meatchi T, Dusser D, Riquet M. An unusual presentation of solitary fibrous tumour of the pleura: right atrium and inferior vena cava compression. Eur J Cardiothorac Surg. 2002. 22:640–642.
8. Chang JC, Su KY, Chao SF, Hsu YH, Yang GG, Chang BS. Hypoglycemia in a patient with a huge malignant solitary fibrous tumor of the pleura. Pathol Int. 2007. 57:791–793.
9. Robinson LA. Solitary fibrous tumor of the pleura. Cancer Control. 2006. 13:264–269.
10. England DM, Hochholzer L, McCarthy MJ. Localized benign and malignant fibrous tumors of the pleura: a clinicopathologic review of 223 cases. Am J Surg Pathol. 1989. 13:640–658.
11. Moran CA, Suster S, Koss MN. The spectrum of histologic growth patterns in benign and malignant fibrous tumors of the pleura. Semin Diagn Pathol. 1992. 9:169–180.
12. Choi YL, Oh YL, Lee MS, Han JH, Ahn GH. Fine needle aspiration cytology of solitary fibrous tumor of the pleura: report of a case misdiagnosed as denocarcinoma of lung. Korean J Cytopathol. 2001. 12:111–115.
13. Cardillo G, Facciolo F, Cavazzana AO, Capece G, Gasparri R, Martelli M. Localized (solitary) fibrous tumors of the pleura: an analysis of 55 patients. Ann Thorac Surg. 2000. 70:1808–1812.
14. Nonaka M, Kadokura M, Takaba T. Benign solitary fibrous tumor of the parietal pleura which invaded the intercostal muscle. Lung Cancer. 2001. 31:325–329.
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