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Clinical Problem Solving: Pathology
February 1, 2008

Pathology Quiz Case 1: Diagnosis

Author Affiliations

Julia C.IezzoniMD

Arch Otolaryngol Head Neck Surg. 2008;134(2):216. doi:10.1001/archoto.2007.28-b

Solitary fibrous tumor, a generally benign spindle cell neoplasm that originates from the visceral or parietal pleura and less commonly from other serosal surfaces, was first described by Klemperer and Rabin1in 1931. It was initially termed localized mesotheliomabecause it was believed to arise from mesothelial cells.2However, immunohistochemical evidence has revealed that the tumor has a mesenchymal and not a mesothelial phenotype. Solitary fibrous tumors express vimentin, which is a marker of mesenchymal cells, and do not express cytoplasmic keratins, which are found in mesotheliomas.2On the other hand, they have recently been described in a variety of extrapleural sites that are not associated with serosal surfaces,3including the head and neck region. Although their occurrence in the head and neck region is very rare, some reported locations include the upper respiratory tract and major salivary glands.4-6

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