Tuberc Respir Dis.  2008 Oct;65(4):334-338.

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

• Park HS
• Kwak HJ
• Park DW
• Koo TY
• Kim HY
• Park SY
• Ahn SE
• Kim SH
• Kim TH
• Sohn JW
• Chung WS
• Yoon HJ
• Shin DH
• Park SS

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.

Keyword

solitary fibrous tumor of pleura; respiratory failure; generalized edema

MeSH Terms

Aged
Anti-Bacterial Agents
Chest Pain
Cough
Displacement (Psychology)
Dyspnea
Edema
Female
Humans
Lung
Pleura
Pneumonia
Pulmonary Atelectasis
Recurrence
Respiration, Artificial
Respiratory Insufficiency
Shock, Septic
Solitary Fibrous Tumor, Pleural
Solitary Fibrous Tumors
Thoracic Cavity
Thorax
Anti-Bacterial Agents

Figure

• 

  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).

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  Figure 2 Gross appearance of the tumor. The cut section shows a well circumscribed encapsulate white mass, measuring 18×13×5 cm.

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  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).

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