Abstract
A solitary fibrous tumor (SFT) is an unusual spindle cell neoplasm that usually arises in the pleura but rarely occurs in the kidney. Despite its rarity, histological diagnosis of SFT is crucial to avoid misdiagnosis with other malignant tumors in the kidney. We report a SFT of the left kidney that presented as a malignant tumor on radiographic findings in a 75-year-old Japanese woman. The tumor was well circumscribed and composed of a mixture of spindle cells and dense collagenous bands with no areas of necrosis or cystic changes noted macroscopically or microscopically. Electron microscopy showed fibroblast-like cells with well-developed rough endoplasmic reticulum, surrounded with collagen fibers. Immunohistochemistry revealed reactivity for vimentin, CD34, Bcl-2, and CD99, but no staining for cytokeratin, S-100, desmin, actin, D2-40, or epithelial membrane antigen (EMA). These findings were compatible with those of SFT. Although SFT of the kidney is extremely rare, this tumor must be included in the differential diagnosis when we encounter renal tumors consisting of mesenchymal elements. Immunohistochemical study is the key to diagnosis for SFT, and ultrastructural study is useful for its diagnosis.
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References
de Perrot M, Fischer S, Brundler MA, Sekine Y, Keshavjee S (2002) Solitary fibrous tumors of the pleura. Ann Thorac Surg 74:286–293
Vallat-Decouvelaere AV, Dry SM, Fletcher SD (1998) Atypical and malignant solitary fibrous tumors in extrathoracic locations: evidence of their comparability to intra-thoracic tumors. Am J Surg Pathol 22:1501–1511
Hasegawa T, Matsuno Y, Shimada T, Hasegawa F, Sano T, Hirohashi S (1999) Extrathoracic solitary fibrous tumors: their histological variability and potentially aggressive behavior. Hum Pathol 30:1464–1473
Hanau CA, Miettinen M (1995) Solitary fibrous tumor: histological and immunohistochemical spectrum of benign and malignant variants presenting at different sites. Hum Pathol 26:440–449
Morimitsu Y, Nakajima M, Hisaoka M, Hashimoto H (2000) Extrapleural solitary fibrous tumor: clinicopathologic study of 17 cases and molecular analysis of the p 53 pathway. APMIS 108: 617–625
Gelb AB, Simmons ML, Weidner N (1996) Solitary fibrous tumor involving the renal capsule. Am J Surg Pathol 20:1288–1295
Fukunaga M, Naikido T (1997) Solitary fibrous tumour of the renal peripelvis. Histopathology (Oxf) 30:451–456
Hirabayashi A, Ogura Y, Wakita T, Hayashi N (2008) Solitary fibrous tumor of a kidney: a case report. Hinyokika Kiyo 54:357–359
Magro G, Emmanuele C, Lopes M, Vallone G, Greco P (2008) Solitary fibrous tumour of the kidney with sarcomatous overgrowth: case report and review of the literature. APMIS 115:1020–1025
Fine SW, McCarthy DM, Chan TY, Epstein JI, Argani P (2006) Malignant solitary fibrous tumor of the kidney: report of a case and comprehensive review of the literature. Arch Pathol Lab Med 130:857–861
England DM, Hochholzer L, McCarthy MJ (1989) Localized benign and malignant fibrous tumors of the pleura. A clinicopathologic review of 223 cases. Am J Surg Pathol 13:640–658
Fain JS, Eble J, Nascimento AG, Farrow GM, Bostwick DG (1996). Solitary fibrous tumor of the kidney: report of three cases. J Urol Pathol 4:227–2238
Magro G, Cavallaro V, Torrisi A, Lopes M, Dell’Albani M, Lanzafame S (2002) Intrarenal solitary fibrous tumor of the kidney report of a case with emphasis on the differential diagnosis in the wide spectrum of monomorphous spindle cell tumors of the kidney. Pathol Res Pract 198:37–43
Coffin CM, Watterson J, Priest JR, Dehner LP (1995) Extrapulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor). A clinicopathologic and immunohistochemical study of 84 cases. Am J Surg Pathol 19:859–872
Kuroda N, Hamaguchi N, Ohara M, Hirouchi T, Mizuno K, Hayashi Y, Lee GH (2008) Elastofibroma: a histochemical, immunohistochemical, and ultrastructural study of two patients. Med Mol Morphol 41:179–182
Goillou L, Gebhard S, Coindre JM (2000) Lipomatous hemangiopericytoma: a fat-containing variant of solitary fibrous tumor? Clinicopathologic, immunohistochemical, and ultrastructural analysis of series in favor of a unifying concept. Hum Pathol 31:1108–1115
Erlandson RA (1994) Fibroblastic tumors, fibrohistiocytic tumors. In: Erlandson RA (ed) Diagnostic transmission electron microscopy of tumors: with clinicopathological, immunohistochemical, and cytogenetic correlations. Raven Press, New York, pp 360–374
Yamazaki K, Eyden BP (2007) Pulmonary lipomatous hemangiopericytoma: report of a rare tumor and comparison with solitary fibrous tumor. Ultrastruct Pathol 31:51–61
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Hirano, D., Mashiko, A., Murata, Y. et al. A case of solitary fibrous tumor of the kidney: an immunohistochemical and ultrastructural study with a review of the literature. Med Mol Morphol 42, 239–244 (2009). https://doi.org/10.1007/s00795-009-0456-9
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DOI: https://doi.org/10.1007/s00795-009-0456-9