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Localized Fibrous Tumor of the Pleura
Solitary Fibrous Tumor of the Pleura, Benign Mesothelioma, Pleural Fibroma

General Considerations

  • Rare, mesenchymal primary tumors of the visceral pleura less common than diffuse malignant mesothelioma
  • Localized form is less common and not related to asbestos exposure or smoking
  • LFTP can be either benign or malignant but is much more often benign (7:1)
  • Usually patients are >50 years old
  • Most occur in the inferior portions of the hemithoraces

Clinical Findings

  • May be asymptomatic and found incidentally
  • May produce chest wall pain, cough, hemoptysis, hypertrophic osteoarthropathy or hypoglycemia be cause they secrete insulin-like proteins

Imaging Findings

  • Conventional radiography
    • Well-circumscribed soft tissue mass with sharp  margin applied to a pleural surface, including the fissures
    • Angle it makes with chest wall may be acute or obtuse
    • They can grow very large and occupy half the hemithorax
  • CT
    • Soft-tissue mass applied to pleural surface
    • May have a lobulated contour
    • Avidly enhances but may have lower attenuation areas of necrosis or hemorrhage, especially in larger lesions
    • At least one angle with pleura is more often acute
    • May have small effusion
    • Calcification is rare
    • May have a pedicle that attached tumor to pleura
    • Malignant lesions are more often large and have necrosis
  • MRI
    • T1 low to intermediate and T2 low
    • Intense enhancement with Gadolinium

Differential Diagnosis

  • Biopsy is required to differentiate benign from malignant form


  • Resectable for cure
  • If totally excised, they usually do not recur


  • Hypertrophic osteoarthropathy
  • Hypoglycemia
  • May rarely undergo malignant transformation or recur locally


  • 12% recurrence rate has been cited with an 88% cure overall with resection

Localized Fibrous Tumor of the Pleura

Localized Fibrous Tumor of the Pleura

Localized Fibrous Tumor of the Pleura. Upper photo. Large, pleural-based soft tissue mass abuts pleura in right lower lung with an acute angle (white arrow) and obtuse angle (yellow arrow) where it meets the chest wall. Lower photo: Mediastinal windows show heterogeneous nature of the contrast-enhancing mass with some areas of lower attenuation (blue arrows) most likely representing necrosis.
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eMedicine. Imaging of Localized Fibrous Tumor of the Pleura. MA Meziane and O Lababede

Localized Fibrous Tumors of the Pleura. ML. Rosado-de-Christenson, GF Abbott, HP  McAdams, TJ Franks, and JR Galvin. May 2003 RadioGraphics, 23, 759-783