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. 2012 Jul;22(4):511-21.
doi: 10.1111/j.1750-3639.2011.00552.x. Epub 2011 Dec 22.

Solitary fibrous tumors and hemangiopericytomas of the meninges: overlapping pathological features and common prognostic factors suggest the same spectrum of tumors

Corinne Bouvier  1 , Philippe Métellus, André Maues de Paula, Alexandre Vasiljevic, Anne Jouvet, Jacques Guyotat, Karima Mokhtari, Pascale Varlet, Henry Dufour, Dominique Figarella-Branger
Affiliations

Solitary fibrous tumors and hemangiopericytomas of the meninges: overlapping pathological features and common prognostic factors suggest the same spectrum of tumors

Corinne Bouvier et al. Brain Pathol. 2012 Jul.

Abstract

Meningeal solitary fibrous tumors (SFTs) and hemangiopericytomas (HPCs) are distinct entities in the World Health Organization (WHO) classification of central nervous system (CNS) tumors while they belong to the same spectrum of tumors in other locations. Well-defined histological prognostic factors are also lacking for these tumors. In order to clarify the relationship between SFT and HPC and to find histological and immunohistochemical prognostic factors, we carried out a retrospective study in 89 patients. The following histological parameters were recorded: hypercellularity, collagenic areas, cytonuclear atypias, necrosis, mitotic count per 10 high-power fields, vasculo-nervous adherences defined by engulfment of vessel or nerve by the tumor, brain infiltration. We found overlapping histological and immunohistochemical features between SFT and HPC. The most relevant histological prognostic factors in the whole cohort for both progression-free survival (PFS) and overall survival (OS) in univariate analysis were hypercellularity, high mitotic count (>5 per 10 high-power fields) and necrosis. On the basis of these results, we propose a new grading scheme for these tumors which was of pronostic value for both PFS and OS in uni- and multivariate analysis. As extent of surgery was also a prognostic factor for both PFS and OS in univariate analysis, we propose that management of SFT/HPC might be based both on quality of removal and histological grade.

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Figures

Figure 1
Figure 1
A,B. Microscopic features of a solitary fibrous tumor: characteristic biphasic pattern: cellular areas with staghorn vessels (A, HES X 25) and pseudokeloidal collagenous areas (B, HES X 25). C,D. Microscopic features of a hemangiopericytoma: highly cellular tumor made of oval cells arranged around vessels (C, HES X 40). Heterogenous expression of CD34 by immunohistochemistry (D, X 25).
Figure 2
Figure 2
Microscopic features of malignancy in SFT/HPC. A. High cellularity and high mitotic count (HES X 25). B. Geographical areas of necrosis (HES X10). C. High MIB1LI (X 40). D. Retained positivity for CD34 in a grade III tumor of the SFT/HPC spectrum (X 40).
Figure 3
Figure 3
Survival curves for (A) progression‐free survival according to extent surgery, (B) mitoses, (C) MIB 1 labeling index, (D) Marseille grading system.
Figure 4
Figure 4
Survival curves for (A) overall survival according to extent of surgery, (B) mitoses, (C) necrosis, (D) Marseille grading system.
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