Japanese Journal of Clinical Oncology, Vol 28, Issue 2 86-91, Copyright © 1998 by Foundation for Promotion of Cancer Research
T Hasegawa, Y Matsuno, T Shimoda, S Hirohashi, T Hirose and T Sano
The distinction of solitary fibrous tumors from histologically similar
neoplasms is often difficult because they rarely occur at a variety of
extrapleural sites. CD34 immunoreactivity has recently been recognized to
be an adjunct for the diagnosis of solitary fibrous tumors. However, it is
now known that CD34 staining is not entirely specific for this entity. We
evaluated 23 solitary fibrous tumors and 54 other spindle cell tumors often
considered in the differential diagnosis for immunoreactivity using
monoclonal antibodies directed against bcl-2 protein, which protects cells
from apoptosis and CD34. The patients with solitary fibrous tumors
comprised 11 men and 12 women, ranging in age from 35 to 85 years (mean,
57.6 years). Fourteen tumors arose in the pleura, four in the
retroperitoneum, three in the superficial soft tissue and one each in the
mediastinum and uterine cervix. Nineteen of 23 solitary fibrous tumors
(83%), irrespective of tumor site, demonstrated diffuse cytoplasmic
staining for bcl-2 protein. bcl-2 immunoreactivity was also observed in
five of seven neurofibromas (71%), eight of 10 synovial sarcomas (80%) and
one of three spindle cell lipomas (33%). CD34 immunoreactivity was present
in all but one solitary fibrous tumor (96%), seven of seven neurofibromas
(100%), three of three spindle cell lipomas (100%), five of five
dermatofibrosarcomas (100%), three of three hemangiopericytomas (100%) and
two of seven malignant fibrous histiocytomas (29%). To date, most of the
pleural and extrapleural cases have not shown aggressive features. We
suggest that bcl-2 protein can be used together with CD34 in the diagnosis
of solitary fibrous tumor to distinguish this entity from other spindle
cell neoplasms.
ORIGINAL ARTICLE
Frequent expression of bcl-2 protein in solitary fibrous tumors
Pathology Division, National Cancer Center Research Institute, Tokyo, Japan.
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