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VOLUME 59 , ISSUE 2 ( April-June, 2017 ) > List of Articles

CASE REPORT

Extensive Cystic Changes in a Mediastinal Solitary Fibrous Tumour Causing a Diagnostic Dilemma

Aanchal Kakkar, Sagar Makode, Surendra K. Sharma, Surabhi Vyas, A.K. Bisoi, Mehar Chand Sharma

Keywords : Solitary fibrous tumour, Haemangiopericytoma, Medistinum, STAT6

Citation Information : Kakkar A, Makode S, Sharma SK, Vyas S, Bisoi A, Sharma MC. Extensive Cystic Changes in a Mediastinal Solitary Fibrous Tumour Causing a Diagnostic Dilemma. Indian J Chest Dis Allied Sci 2017; 59 (2):87-90.

DOI: 10.5005/ijcdas-59-2-87

License: CC BY-NC 4.0

Published Online: 18-11-2022

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Extra-pleural solitary fibrous tumours (SFTs) are relatively rare tumours, usually located in the subcutaneous tissue, deep soft tissue of extremeties, retroperitoneum and abdomino-pelvic cavity, and may be difficult to recognise when encountered at unusual locations. Mediastinal SFTs are extremely rare tumours and the occurrence of cystic changes in these tumours is even more rare. We report the case of a 35-year-old male with a posterior-superior mediastinal mass with extensive cystic change causing a diagnostic dilemma. Histopathological examination revealed a tumour with extensive cystic change, with the cystic spaces containing blood. The solid areas showed plump, round to oval cells arranged in a pattern-less pattern, with a prominent Staghorn pattern of vasculature. Tumour cells were immunopositive for CD99, B-cell lymphoma-2 (bcl2), and CD34 (focally), leading to a diagnosis of SFT, which was confirmed by nuclear immunopositivity for signal transducer and activator of transcription 6 (STAT6). In view of the atypical clinical and radiological features and the many morphological mimics, an appropriate immunohistochemical panel is extremely useful in arriving at the right diagnosis, particularly STAT6 immunohistochemistry which identifies the molecular signature characteristic of SFT/haemangiopericytoma group of tumours. Also, mediastinal SFTs are associated with unusually aggressive behaviour, unlike at other sites; thus, patients with mediastinal SFT should be followed-up for a prolonged period.


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