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Vol. 32. Issue 1.
Pages 43-46 (January 1996)
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Vol. 32. Issue 1.
Pages 43-46 (January 1996)
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Tumor fibroso localizado intraparenquimatoso. A propósito de dos casos, uno de ellos múltiple y bilateral
Localized fibrous tumor in the parenchyma. Two cases: one both multiple and bilateral
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J.C. Vázquez-Pelillo*, E. Peña, N. Moreno, E. Orusco, F. González-Aragoneses, E. Folqué
Servicio de Cirugía Torácica. Hospital General Universitario Gregorio Marañón. Madrid
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El tumor fibroso localizado es una neoplasia poco frecuente, que se localiza habitualmente en la pleura visceral. Histológicamente están compuestos por fascículos dispuestos al azar o entrelazados de células fusiformes, entre las que se aprecia una cantidad variable de colágeno; su origen se establece, para la mayoría de los autores, en células mesenquimáticas submesoteliales. Clínicamente suelen ser asintomáticos, aunque, a veces, producen hipoglucemia, osteoartropatía hipertrófica u otros síntomas, siendo el tratamiento de elección su resección completa. Los métodos de imagen sirven de gran ayuda para establecer una estrategia quirúrgica, aunque es habitual que se llegue a la intervención quirúrgica sin un diagnóstico histopatológico. Este artículo presenta dos casos de fibromas intrapulmonares, que son histológicamente idénticos a los tumores fibrosos localizados de la pleura. El hallazgo de una localización intraparenquimatosa constituye una rareza, siendo la presentación múltiple y bilateral excepcional, descrita tan sólo en una ocasión. De nuestros 2 casos, uno de ellos se presenta como un nodulo pulmonar solitario de hallazgo casual radiológico, y el otro en forma de múltiples nodulos bilaterales, que requirió varias intervenciones, siendo de localización intraparenquimatosa, a diferencia del caso mencionado, lo cual supone que sea la primera vez que se describe un caso de estas características. Se discuten, así mismo, aspectos clínicos, terapéuticos e histopatológicos de estos tumores y se hace una revisión de la literatura.

Palabras clave:
Tumor fibroso localizado de la pleuramesotelioma fibroso benigno
Fibroma de pulmón y pleura

Localized fibrous tumor is an uncommon neoplasm that is usually located in the visceral pleura. Histologically these tumors are composed of randomly arranged fascicles or networks of fusiform cells, among which there is a varying amount of collagen. Most authors consider that these cells origínate in submesothelial mesenchymal cells. The condition is normally silent, though hypoglycemia, hypertrophic osteoarthropathy or other symptoms sometimes result. The treatment of choice is total resection and imaging techniques are extremely helpful for establishing surgical strategy, eventhough surgery is often performed before a histopathologic diagnosis is available.

We present 2 patients with intrapulmonary fibromas that were histologically identical to localized fibrous pleural tumors. These tumors are rarely found in the parenchyma and multiple bilateral presentation is exceptional, having been described only once in the literature. One of our patients had a single pulmonary node that happened to be noticed on an X-ray. The other had multiple bilateral nodes that required several surgical procedures; the intraparenchymatous location for this type of tumor has not been described to date. We discuss clinical, therapeutic and histopathological aspects of these tumors and review the literature.

Key words:
Localized fibrous tumor of the pleura
Benign pleural mesothelioma
Fibroma of the lung and pleura
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Copyright © 1996. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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