Meninges, Solitary fibrous tumour [LMP98268]

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Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Neoplasia
Diagnosis: 
Solitary fibrous tumour
Species: 
Human
Organ System: 
Central Nervous System
Gender: 
Male
Age: 
38 years
Diagnosis Code: 
ICD-10: D32 | ICD-O: 8815/0
Slide Contributor Information
Gao, A., Keith, J.

Keywords

Meninges, dural-based tumour, SFT, hemangiopericytoma, HPC

Clinical History

38-year-old man with a dural-based mass.

Clinical Discussion

Solitary fibrous tumour (SFT) is a fibroblastic mesenchymal neoplasm, predominantly of adults, that can occur in essentially any location, including the meninges. The term hemangiopericytoma, describing a diffusely cellular neoplasm having many overlapping features with SFT, is considered obsolete as the two are now recognized as being the same entity, sharing a recurrent intrachromosomal rearrangement (12q) resulting in NAB2-STAT6 fusion. Microscopically, SFT shows patternless ovoid to spindle cells in a fibrous stroma with abundant collagen. A staghorn vascular pattern is prominent and characteristic. In this case, areas of increased cellularity resemble classic hemangiopericytoma. A fat-forming variant has been described. Grading is based on mitoses, hypercellularity, and necrosis. Immunohistochemistry shows positivity for CD34, CD99, and bcl2. Aberrant localization of STAT6 to the nucleus (due to NAB2-STAT6 fusion) can be detected with STAT6 immunohistochemistry and is sensitive and specific. Prognosis varies from benign to aggressive, correlated with tumour grade.