Brief Report: Activity of Imatinib in a Patient with Platelet-Derived-Growth-Factor Receptor Positive Malignant Solitary Fibrous Tumor of the Pleura

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Brief Report: Activity of Imatinib in a Patient with Platelet-Derived-Growth-Factor Receptor Positive Malignant Solitary Fibrous Tumor of the Pleura Tommaso De Pas, Francesca Toffalorio, Piergiuseppe Colombo, Giuseppe Trifirò, Giuseppe Pelosi, Paolo Della Vigna, Michela Manzotti, Monica Agostini, Filippo de Braud Journal of Thoracic Oncology Volume 3, Issue 8, Pages 938-941 (August 2008) DOI: 10.1097/JTO.0b013e3181803f08 Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 The tumor was composed of short spindle cells with haphazard distribution, hypercellular areas, and varying degrees of keloid-type collagen deposition. Medium-sized thin-walled blood vessels in a hemangiopericytic growth pattern were also observed (inset, upper left corner). Increased mitotic activity and coagulative necrosis (inset, lower right corner) qualified histologically the malignant nature of the tumor. Journal of Thoracic Oncology 2008 3, 938-941DOI: (10.1097/JTO.0b013e3181803f08) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 A, Histology of the tumor revealing an haphazard growth pattern of ovoid and spindle cells separated by a background of rope-like collagenized stroma, and showing a typical patternless appearance. B, The tumor diffusely expressed the ligand PDGF A in the cytoplasm and in the endothelial cells. C, D, Immunoreactivity for PDGFRα (C) and for PDGFRβ (D) in the tumor cells and in the stroma. E, Immunoreactivity for c-KIT was not detected (see the positivity in an intratumoral mast cell as internal control). F, No reactivity for phospho-PDGFR-β was found in the tumor (inset: positive control from a chordoma). (A, Hematoxylin and Eosin, original magnification ×200). (B–F, Immunohistochemistry, original magnification ×200). Journal of Thoracic Oncology 2008 3, 938-941DOI: (10.1097/JTO.0b013e3181803f08) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 CT-PET scan images representing the Suv bw max of the 2 main lesions, the retrosternal (panels A) and the parasternal (panels B). The corresponding graphs illustrate the trend of Suv bw max during the whole treatment. The arrows indicate: 1. start of the treatment, 2. tumor response to Imatinib 400 mg/day, 3. first disease evaluation after treatment discontinuation, 4. tumor response after reintroduction of Imatinib 800 mg/day. Note: the first patient's radiologic assessment was performed in an external hospital and it was not a CT-PET scan image. Journal of Thoracic Oncology 2008 3, 938-941DOI: (10.1097/JTO.0b013e3181803f08) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions