Solitary fibrous tumor of the pleura mimicking pleural effusion

Flávia Kessler Borges, Caroline Machado Rotta Dornelles, Analu Vivian
2015 Clinical and Biomedical Research  
We describe a case of a 62-year-old female patient with dry cough over the last year. She was previously healthy, except for hypertension, and had no history of smoking. She sought medical care for mild dyspnea, wheezing, and cough. Firstly, chest X-ray suggested pleural effusion affecting about two-thirds of the left lung. A thoracentesis was tried without success. During hospitalization, a chest computerized tomography (CT) scan was performed, showing a large lesion with slightly
more » ... ightly heterogeneous tumescent soft tissue attenuation occupying two-thirds of the left hemithorax, measuring 13×15×16 cm, and displacing mediastinal structures contralaterally ( figure 1 ). An ultrasound-guided thoracic biopsy was performed. Histopathological examination identified a mesenchymal neoplasm of spindle cells with low mitotic index and hypercellular areas alternating with predominantly collagenous areas, suggesting the diagnosis of solitary fibrous tumor of the pleura (SFTP). The patient underwent thoracic surgery, which identified a strongly vascularized bulky oval lesion adhered to the diaphragm cranially and pressing the entire left lung (figure 2). Resection of the lesion and the diaphragmatic portion adhered to the tumor was performed in addition to inferior left lobe segmentectomy. The histopathological analysis confirmed a visceral SFTP without features of malignancy.
doi:10.4322/2357-9730.52594 fatcat:5wtx4gmjrvabxjhbdvkzkojeli