Extrapleural solitary fibrous tumor: A distinct entity from pleural solitary fibrous tumor. An update on clinical, molecular and diagnostic features

Andrea Ronchi, Immacolata Cozzolino, Federica Zito Marino, Marina Accardo, Marco Montella, Iacopo Panarese, Giuseppe Roccuzzo, Giorgio Toni, Renato Franco, Annarosaria De Chiara

Research output: Contribution to journalReview articlepeer-review

Abstract

Solitary fibrous tumor (SFT) is a mesenchymal neoplasm that was originally described to be localized in the pleura, but thereafter, this has been reported in several anatomic sites. Although the etiology of the neoplasm remains largely unknown, the pathogenesis seems to be related to an NAB2–STAT6 fusion gene due to paracentric inversion on chromosome 12q13. The diagnosis of extrapleural SFT is challenging, owing to its rarity, and requires an integrated approach that includes specific clinical, histological, immunohistochemical, and even molecular findings. Histologically, extrapleural SFT shares morphological features same as those of the pleural SFT because it is characterized by a patternless distribution of both oval- and spindle-shaped cells in a variable collagen stroma. In addition, morphological variants of mixoid, fat-forming, and giant cell–rich tumors are described. A correct diagnosis is mandatory for a proper therapy and management of the patients with extrapleural SFT, as extrapleural SFT is usually more aggressive than pleural form, particularly cases occurring in the mediastinum, retroperitoneum, pelvis, and meninges. Although SFT is usually considered as a clinically indolent neoplasm, the prognosis is substantially unpredictable and only partially related to morphological features. In this context, cellularity, neoplastic borders, cellular atypias, and mitotic activity can show a wide range of variability. We review extrapleural SFT by discussing diagnostic clues, differential diagnosis, recent molecular findings, and prognostic factors.

Original languageEnglish
Pages (from-to)142-150
Number of pages9
JournalAnnals of Diagnostic Pathology
Volume34
DOIs
Publication statusPublished - Jun 1 2018

Keywords

  • Dedifferentiation
  • Extrapleural Solitary Fibrous Tumor
  • Hemangiopericytoma
  • NAB2
  • Soft Tissue Neoplasm
  • STAT6

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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