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Communications to the Editor |

Confident Diagnosis of Solitary Fibrous Tumor of the Pleura Using Cutting-Needle Biopsy FREE TO VIEW

Philippe Collard, MD; Birgit Weynand, MD
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Cliniques Universitaires Saint-Luc Université Catholique de Louvain Brussels, Belgium

Correspondence to: Philippe Collard, MD, Cliniques Universitaires Saint-Luc, Av Hippocrate 10, 1200 Brussels, Belgium; e-mail: collard@pneu.ucl.ac.be



Chest. 2000;117(2):613-614. doi:10.1378/chest.117.2.613-a
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To the Editor:

In a recent issue (June 1999), Urschel et al1 presented a case of solitary fibrous tumor of the pleura. They stated that “ultimately, thoracotomy and tumor resection are usually required for diagnosis.” Until recently, such a statement was common and undisputed.2However, we have published an article (November 1997)3 providing strong evidence that a confident preoperative diagnosis of fibrous tumor of the pleura can be made by histologic and immunohistochemical analysis of material obtained by transthoracic cutting-needle biopsy. The biopsy can be done safely within a few minutes under radioscopic guidance, even in an outpatient setting. The cost of this minimally invasive procedure is low. Making the definitive diagnosis allows for a proper planification of a curative thoracotomy. The resection of a solitary fibrous tumor of the pleura is usually simple because the lesion is attached to the pleura, well-circumscribed, and often pedunculated. Hence, good outcome can be contemplated after surgical cure, even in patients with bad pulmonary reserve or poor general status. This is often not the case when an alternative diagnosis is made with the cutting-needle biopsy, such as malignant mesothelioma or some cases of peripheral lung cancer. Thus, making the diagnosis of solitary fibrous tumor of the pleura by cutting-needle biopsy permits a proper and cost-effective allocation of medical resources.

References

Urschel, JD, Anderson, TM, Whooley, BP (1999) Finger clubbing and a lung mass.Chest115,1735-1737
 
Light, RW Malignant and benign mesotheliomas. Light, RW eds.Pleural diseases 3rd ed.1995,125-126 Williams & Wilkins. Baltimore, MD:
 
Weynand, B, Noël, H, Goncette, L, et al Solitary fibrous tumor of the pleura. a report of five cases diagnosed by transthoracic cutting needle biopsy.Chest1997;112,1424-1428
 

Figures

Tables

References

Urschel, JD, Anderson, TM, Whooley, BP (1999) Finger clubbing and a lung mass.Chest115,1735-1737
 
Light, RW Malignant and benign mesotheliomas. Light, RW eds.Pleural diseases 3rd ed.1995,125-126 Williams & Wilkins. Baltimore, MD:
 
Weynand, B, Noël, H, Goncette, L, et al Solitary fibrous tumor of the pleura. a report of five cases diagnosed by transthoracic cutting needle biopsy.Chest1997;112,1424-1428
 
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