PMC5566411_01
Chest X-ray showing left sided pleural effusion.
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The chest x-ray revealed a large left sided pleural effusion (Figure 1).
Computed tomography scan of the chest showing left sided lung mass.
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On noncontrast computed tomography of the chest, a large heterogeneously enhancing left lung mass with pleural effusion was seen (Figure 2), so ultrasound-guided fine needle aspiration cytology was advised for further diagnosis.
(A) An immunohistochemical stain for BCL-2 performed on the biopsy specimen. (B) An immunohistochemical stain for CD34 performed on the biopsy specimen.
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On immunohistochemistry analysis, the specimen was immunoreactive to BCL-2 and CD34. (Figure 3A and 3B) Chromogranin A and Synaptophysin were nonimmunoreactive.
Surgical resection of tumor through left lateral thoracotomy approach.
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A left lateral thoracotomy was performed for resection of the pleural mass. (Figure 4) A large tumor originating over the surfaces of the left lower and middle lobe was found, and this was not invading fissure and lingula.
Gross specimen of the SFT of left lung which is well circumscribed, encapsulated, and measuring 12x10x8 cm in size.. Abbreviation: SFT, solitary fibrous tumor.
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The tumor was well circumscribed and encapsulated, measuring 12x10x8 cm in size. (Figure 5) True hypoglycemia, low insulin and c-peptide, and resolution of hypoglycemia after resection of a tumor confirmed solitary fibrous tumor (SFT) with Doege-Potter syndrome (DPS) as the etiology of hypoglycemia.