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孤立性纤维性肿瘤(solitary fibrous tumor,SFT)是一种来源于间叶细胞的梭形细胞肿瘤,大多发生于胸膜。为分析累及胸膜的SFT临床特征,回顾性分析遵义医学院附属医院2015年8月经内科胸腔镜检查确诊的1例累及壁层胸膜的SFT临床资料。该患者为男性,45岁,首诊主要症状为胸痛、咳嗽、咳痰、气促半月;胸部CT检查见右侧胸腔大量积液,部分包裹,胸腔占位性病变,右肺部分肺不张,考虑恶性肿瘤,疑右侧2、3肋骨转移;活组织病理检查免疫组织化学结果示CD34(+);细胞角蛋白(cytokeratin,CK)(–),CK 5/6(–),细胞内钙结合蛋白(calretinin,CR)(–),上皮膜抗原(epithelial membrane antigen,EMA)(–),间皮细胞(mesothelial cell,MC)(–),波形蛋白(vimentin,Vim)(++);肾母细胞瘤(Wilm’s tumor-1,WT-1)(+),Bcl-2(+),CD56(–),CD99(+),结蛋白(desmin)(–),甲状腺转录因子-1(thyroid transcription factor-1,TT F1)(–)。诊断为右侧壁层胸膜SFT。SFT是一种少见疾病,可发生于全身各部位,临床症状无特异性,可无症状或咳嗽、胸痛、呼吸困难、咯血等;确诊需病理和免疫组织化学结果,多为良性;治疗以手术完整切除肿瘤为主,预后相对较好,需长期随访。
Solitary fibrous tumor (solitary fibrous tumor, SFT) is a mesenchymal tumor derived from mesenchyme, mostly in the pleura. To analyze the clinical features of SFT involving the pleura, one case of SFT involving the parietal pleura diagnosed by medical thoracoscopy in August 2015 in Zunyi Medical College Affiliated Hospital was retrospectively analyzed. The patient was male, 45 years old. The main symptoms of the first visit were chest pain, cough, expectoration and half a month of gas. Chest CT showed pleural effusion on the right side of the chest, partial parietal lesions, pleural space-occupying lesions, , Consider the right side of the 2, 3 ribs metastasis; biopsy pathology immunohistochemistry showed CD34 (+); cytokeratin (CK) (-), CK 5/6 (-), intracellular Calretinin (CR), epithelial membrane antigen (-), mesothelial cell (MC), vimentin (Vim) (++) , Wilm’s tumor-1 (WT), Bcl-2 (+), CD56 (-), CD99 (+), desmin (-), thyroid transcription factor-1 (thyroid transcription factor-1, TT F1) (-). Diagnosis of right parietal pleural SFT. SFT is a rare disease that can occur in all parts of the body, the clinical symptoms of non-specific, asymptomatic or cough, chest pain, dyspnea, hemoptysis, etc .; confirmed pathological and immunohistochemical findings, mostly benign; treatment with surgery Complete resection of the tumor, the prognosis is relatively good, requiring long-term follow-up.