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Presented by George Netto, M.D. and prepared by Priya Banerjee, M.D.
Case 5: 55 years old male was found to have a 6.5 perirenal/retroperitoneal mass on imaging studies.
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1. Question
Week 386: Case 5
55 years old male was found to have a 6.5 perirenal/retroperitoneal mass on imaging studies performed for right flank pain.images/S0915204_A.jpg
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images/S0915204_BCL2.jpg
images/S0915204_CD34.jpgCorrect
Answer: Solitary fibrous tumor (SFT)
Histology: see below
Discussion: SFT can rarely arise in renal hilum and perirenal/ retroperitoneal location. Microscopically, they have similar features to those identified in other soft tissue location. SFTs are composed of uniform spindled cells with bland nuclei, arranged in a “patternless” pattern in a hemangiopericytomatous background containing variable amounts of ropy collagen.
Careful follow-up is warranted in lesions with marked hypercellularity, nuclear pleomorphism, necrosis and or infiltrative margins due to their potential aggressive biologic behavior. Immunohistochemistry generally reveals diffuse reactivity for CD34, vimentin and bcl-2. Staining for CD99, beta-catenin, p53, smooth muscle actin, and muscle-specific actin has also been reported. SFT is typically negative for pancytokeratin, S-100, and CD117 (c-kit).
Incorrect
Answer: Solitary fibrous tumor (SFT)
Histology: see below
Discussion: SFT can rarely arise in renal hilum and perirenal/ retroperitoneal location. Microscopically, they have similar features to those identified in other soft tissue location. SFTs are composed of uniform spindled cells with bland nuclei, arranged in a “patternless” pattern in a hemangiopericytomatous background containing variable amounts of ropy collagen.
Careful follow-up is warranted in lesions with marked hypercellularity, nuclear pleomorphism, necrosis and or infiltrative margins due to their potential aggressive biologic behavior. Immunohistochemistry generally reveals diffuse reactivity for CD34, vimentin and bcl-2. Staining for CD99, beta-catenin, p53, smooth muscle actin, and muscle-specific actin has also been reported. SFT is typically negative for pancytokeratin, S-100, and CD117 (c-kit).
