Inflammatory pseudotumor of lymph nodes

A case of inflammatory pseudotumor in a 22-Year-old man is described. Symptoms and signs showed high fever and prominent cervical lymphadenopathy; laboratory findings were consistent with an acute inflammatory process. Diagnosis was reached through a lymph node biopsy which allowed a definitive diagnosis and ruled out several mimicking pathological processes such as malignant lymphoma, infectious diseases and autoimmune disorders. Inflammatory pseudotumor should be included in the differential diagnosis of patients with persistent fever and lymph node enlargement.     

Inflammatory pseudotumor of the esophagus

Inflammatory pseudotumors of the esophagus are uncommon. They pose diagnostic and therapeutic dilemmas, especially when located in the cervical esophagus. History and physical examination are rarely contributory. Routine radiologic investigations including barium swallow and computed tomography only raise the suspicion of a benign esophageal neoplasm. Esophagoscopy and biopsy do not provide a definite diagnosis, as these 'tumors' are frequently submucosal, unless they enlarge sufficiently to cause mucosal ulcerations. Endoscopic ultrasonography may accurately localize the tumor but is not diagnostic. Conservative surgical resection or debulking would be both diagnostic and therapeutic. Steroids, cyclophosphamide and low-dose radiotherapy may at best be considered second-line therapy. One such case of inflammatory pseudotumor of the cervical esophagus is presented and the relevant literature is reviewed. Our patient could not be diagnosed on preoperative investigations and required an esophagotomy with frozen section. We debulked the mass and the patient is asymptomatic 6 months after surgery.     

Inflammatory pseudotumor of the retroperitoneum

Inflammatory pseudotumor is a rare, benign lesion of various organs and tissues, characterized by proliferating fibrovascular tissue admixed with inflammatory cells of etiology and pathogenesis that are largely unknown. We report a case of a 55-years-old woman with acute pancreatitis with a retroperitoneal mass in Morrison's space detected by tomography. Aspects concerning incidence, etiology, clinical, and histopathologic characteristics are discussed.     

Inflammatory pseudotumor of the lung

Inflammatory pseudotumors of the lung are uncommon in the thoracic surgical literature. These masses resemble carcinoma of the lung radiographically and are discovered only at time the of histologic review of the resected specimen. We report a case of inflammatory pseudotumor that was excised without pulmonary resection, although it completely filled the right hemithorax. We think it was the greatest inflammatory pseudotumor in the English literature.     

Inflammatory pseudotumor of the liver

Inflammatory lesions in the liver simulating tumor formation are rare. Eleven cases have so far been reported in the literature, most of them in recent years. We present an additional case of an "inflammatory pseudotumor" in a 17-year-old male. The inflammatory pseudotumor should be kept in mind in the differential diagnosis of hepatic space-occupying lesions.     

Inflammatory pseudotumor of the pancreas

Summary We describe a rare example of inflammatory pseudotumor of the pancreas in a 42-yr-old woman, which developed following chemotherapy for lymphoma of the uterine cervix. The patient had developed fatigue, weight loss abdominal pain, and anemia; abdominal CT scan showed a large mass in the pancreas. Examination of the resected specimen revealed a fleshy, well-circumscribed, 7-cm mass., Histologically, there was a hypocellular to moderately hypercellular, bland spindle-cell proliferation admixed with a prominent infiltrate of lymphocytes, histiocytes, and plasma cells. The spindle cells were vimentin positive but negative for muscle markers; electron microscopy revealed only fibroblastic cells. DNA analysis revealed a diploid population with low S-phase fraction. The patient was well at 6-mo follow-up. It is important for the pathologist to be aware of the existence of this entity in unusual locations such as the pancreas so as to avoid a mistaken diagnosis of malignancy.     

Inflammatory pseudotumor of the liver

Inflammatory pseudotumor of the liver (IPL) is a rare benign neoplasm. It often masquerades as a malignancy, either primary or metastatic. We describe the case of a 71-year-old man who presented with fever and malaise. Workup revealed a cecal mass, as well as a lesion in the left lobe of the liver. Pathologic examination showed a cecal neoplasm and a hepatic inflammatory pseudotumor. The patient recovered uneventfully. This case highlights the ability of IPL to masquerade as a malignant hepatic neoplasm, and emphasizes the difficulties in diagnosis.     

Inflammatory pseudotumor of the liver]

Inflammatory pseudotumor is a pathological process whose cause is unknown, and whose macroscopic appearance is that of a malignant tumor, but it is in fact of inflammatory nature. Inflammatory pseudotumor of the liver is infrequent, but must be taken into account in the differential diagnosis of liver masses. A case report is presented, with review of the literature. Because of its benign nature, an aggressive approach is not recommended.     

Inflammatory pseudotumor of the lung]

The patient was a 76-year-old man whose chief complaint was a dry cough. His chest X-ray film revealed a large hazy shadow with unclear margin in the left upper lobe. Bronchiolitis obliterans organizing pneumonia was initially diagnosed because transbronchial lung biopsy (TBLB) specimens showed organizing pneumonia with no evidence of malignancy. However, because the hazy shadow increased gradually in size despite steroid therapy. TBLBs were performed several more times to confirm the diagnosis. The last TBLB specimen showed proliferation of fibroblasts and mononuclear cells, with marked infiltration mainly of plasma cells 12 months after the initiation of steroid therapy. Because we were unable to obtain a histological diagnosis by bronchofiberscopy, a left upper lobectomy was preformed and the lesion resected. Histology disclosed inflammatory pseudotumor of a lymphoplasmacytic type with organizing pneumonia. The results of an immuno-histochemical examination confirmed that the proliferating plasma cells were polyclonal. These findings suggest that inflammatory pseudotumors should be taken into account by differential diagnoses of cases of organizing pneumonia that are resistant to steroid therapy.     

Inflammatory pseudotumor of the spleen.

The case of a 39-year-old man with inflammatory pseudotumor of the spleen is presented. This is an extremely rare benign lesion with histologic features of non-specific inflammatory and reparative changes. The literature is reviewed and this case is compared clinically and radiologically with the previously reported cases.     

Inflammatory pseudotumor: A diagnostic dilemma

Inflammatory pseudotumor (IP) is a disorder that constitutes a differential diagnosis of a series of clinical conditions due to a large spectrum of manifestations in presentation since it can involve any organ of the human body. Its basic characteristic is the appearance of inflammatory masses whose symptoms depend on their location. We describe two cases of IP that clearly illustrate this diversity of presentation and we review the diagnostic and therapeutic strategies for such a condition.     

Inflammatory pseudotumor of intra-abdominal lymph nodes manifesting as recurrent fever of unknown origin: a case report

A 27-year-old man presented with a 7-month history of debilitating recurrent fever and weight loss. Extensive clinical evaluation led to the discovery of splenomegaly and retroperitoneal lymphadenopathy. The patient underwent splenectomy as well as liver and lymph node biopsy. Histologic examination of the lymph nodes, but not the liver and spleen, revealed inflammatory pseudotumor of lymph nodes. The patient has remained asymptomatic for more than 3 years following the surgical procedure despite the absence of further intervention. Inflammatory pseudotumor of lymph nodes should be considered in the differential evaluation of prolonged or relapsing fever of unknown etiology.     

Inflammatory pseudotumor of the liver and pregnancy

Inflammatory pseudotumor of the liver (IPL) is a rare, nonneoplastic entity of unknown etiology. Our patient represents the first reported case of IPL that was managed conservatively during an intrauterine pregnancy.     

Inflammatory pseudotumor of the liver treated surgically

This report describes the case of an inflammatory pseudotumor of the liver in a 61 year-old female, diagnosed by an ultrasound scan (USG), computed tomography (CT) and needle biopsy. The right hemihepatectomy has been carried out. There were no complications in the post-operative course.     

Inflammatory pseudotumor of the liver and spleen

We report the case of a 44-year-old woman with an inflammatory pseudotumour of the liver and spleen. This concomitant association has been rarely described. Our patient presented with a 2-day history of low grade fever and pain in the right hypochondrium and lower abdomen, and an abdominal scan revealed a contrast-enhanced mass in the liver in addition to an enlarged spleen with another contrast-enhanced mass. The patient was admitted to the hospital with the diagnosis of multiple liver abscesses and a spleen mass which suggested a neoplasm such as lymphoma. The final diagnosis was made by ultrasound-guided liver mass biopsy, and splenectomy. We review the literature, and highlight the difficulties of diagnosing this entity.