Surgically treated pulmonary inflammatory pseudotumor

We report 2 cases diagnosed as so-called pulmonary inflammatory pseudotumor. In case 1, a 28-year-old man with a slow growing 6-cm pulmonary tumor who underwent a right upper lobectomy was diagnosed with an inflammatory myofibroblastic tumor. In case 2, a 55-year-old man with chest pain and cough, who underwent open lung biopsy was diagnosed with plasma cell granuloma. Despite both diagnoses being classified as pulmonary inflammatory pseudotumors, we believe they should be classified differently.     

Multiple inflammatory pseudotumors mimicking liver metastasis from colon cancer: Report of a case

(Received for publication on Apr. 22, 1999; accepted on Jan. 7, 2000)     

Inflammatory myofibroblastic tumor (inflammatory pseudotumor) of the neck infiltrating the trachea

Inflammatory myofibroblastic tumor (IMT), popularly known as inflammatory pseudotumor, is a slow growing quasi-neoplastic lesion with a distinct histologic appearance and benign clinical course. A case of a neck IMT with infiltration into the trachea causing asthmalike symptoms in a 12-year-old girl is described. Both tracheal and neck IMT have been described, but no other case has displayed this infiltration. A review of the pertinent literature and the etiology, diagnosis, treatment, and outcomes of this tumor are discussed. It is important to consider IMT in a differential diagnosis because it can be easily misdiagnosed as a malignancy. A surgeon must not perform radical surgery, radiation, or chemotherapy until a final pathologic diagnosis is made because of the nature of this lesion.     

Retroperitoneal inflammatory myofibroblastic tumor

Inflammatory myofibroblastic tumors are rare, and those located retroperitoneally are even rarer. The authors present the case of a 52-year-old male farmer with a lump in the lower abdomen of 2 months in duration that was retroperitoneal in location. It was excised, and histopathologic examination revealed an inflammatory myofibroblastic tumor. The present case is presented by virtue of its rare location.     

A rare lesion of the central nervous system: inflammatory pseudotumor

Inflammatory pseudotumor is an uncommon tumor, initially described in the lung, but which can involve various organs. It is a controversial entity. We report the case of a 19-year-old-man with an inflammatory pseudotumor localized in the central nervous system, revealed by epilepsy. Characteristically, the inflammatory pseudotumor is an inflammatory mass leading to manifestations related to its localization. Relatively ubiquitous, this tumor is seldom described in the central nervous system. This uncommon lesion is part of a heterogeneous group of entities which are difficult to diagnose for both surgical pathologists and clinicians.     

Complete surgical resection of inflammatory myofibroblastic tumor with carinal reconstruction in a 4-year-old boy

Inflammatory myofibroblastic tumor of the carina and the main bronchus is a rare tumor. The authors report here on a case of a 4-year-old boy with an inflammatory myofibroblastic tumor at the carina and extending to the left main bronchus. He presented with fever and a cough of 2 months' duration. Preoperative assessment of the tumor revealed an intraluminal round mass arising from the carina and extending into the left main bronchus, and this caused near-total obstruction of the left main bronchus and the subsequent total collapse of the entire left lung. The complete resection of the mass with carinal reconstruction was successful. The tumor was a round mass measuring 1.5 × 1 cm. It had characteristic features of an inflammatory myofibroblastic tumor, namely, the proliferation of spindle-shaped fibroblasts and myofibroblasts.     

Abdominal inflammatory myofibroblastic tumor a clinicopathologic study with reappraisal of biologic behavior

Background and Purpose

Inflammatory myofibroblastic tumor (IMT) is a proliferative lesion of controversial nosology and uncertain prognosis. In an attempt to acquire further understanding of pathogenesis and biologic behavior, we surveyed abdominal IMTs managed over the last 12 years at a single institution.

Methods

Intra-abdominal IMTs treated between 1995 and 2007 were reviewed concerning demographic, clinical, and pathologic features as well as therapeutic management and outcome. All specimens were reevaluated by histologic examination and immunohistochemistry.

Results

There were 7 patients (4 males; age range, 28 days to 14 years). Five lesions were located in alimentary tract: 1 gastric presenting with bleeding, 1 hepatic presenting with a thoracic wall mass, 1 pancreatic and 2 colonic presenting with obstructive symptoms. One splenic IMT was found incidentally. The remaining case arose from the adrenal gland and presented with a palpable mass. The gastric and adrenal IMTs had evidence of a previous or concomitant infectious setting. Five lesions were excised. The pancreatic IMT underwent a drainage procedure followed by steroid administration, and the hepatic lesion received antibiotics. Histopathology revealed characteristic findings of IMT. Expression of anaplastic lymphoma kinase was negative in all cases. At a median follow-up of 6 years (range, 3-15), all children were asymptomatic with no recurrences. The hepatic and pancreatic IMT displayed complete and near total regression, respectively.

Conclusion

A benign behavior of abdominal IMTs was observed even in patients not undergoing surgical excision. Although IMT remains a surgical disease, a conservative approach may be reasonable in select cases.     

肝炎性成肌纤维细胞瘤的诊断和外科治疗

目的 探讨肝炎性肌成纤维细胞瘤(hepatic inflammatory myofibroblaRtic tumor,HIMT)的临床表现、CT特点,提出临床策略.方法 回顾性分析2000年1月至2007年6月收治的8例HIMT的患者临床资料,并结合文献进行总结.结果 8例患者中男5例,女3例,平均年龄41.3岁.6例患者无临床症状,所有患者均无肝炎及肝硬化病史.肝功能、血AFP、CEA、CA199均正常.术前超声及CT均未诊断HIMT.CT特点:平扫为均匀的低密度区或混杂低密度区,或病灶内可见不规则低密坏死区;增强扫描1例未见明显强化征象,7例病灶轻至中度强化,强化病灶均表现为动脉晚期病灶实性部分强化程略度高于周围肝组织,至门脉期及延迟扫描,病灶实性部分仍有轻至中度强化,但强化程度低于周围肝实质;8例患者均行手术切除,肿瘤均为单发,直径3～12 cm,均无明显包膜,术后病理结果为HIMT.无围手术期死亡.结论 HIMT无特异性临床症状,术前影像学上缺乏特征性表现难以确诊,但CT扫描具有一定的提示意义,结合临床仍具有一定的诊断价值.手术切除是主要的治疗方法.     

Inflammatory Myofibroblastic Tumor of the Temporal Bone: A Histologically Nonmalignant Lesion with Fatal Outcome

Introduction: Inflammatory myofibroblastic tumor (IMFT) of the temporal bone is an unusual but distinct clinicopathologic entity. Case Report: We report the case of a 75-year-old patient with an IMFT located in the temporal bone. Symptoms included VI, X, XI, and XII cranial nerves palsies. Computed tomography and magnetic resonance images are described. The lesion was locally aggressive and outcome was fatal. IMFT was identified by analysis of postmortem specimen with histopathologic and immunohistochemical confirmation. Discussion: IMFT can be locally destructive lesions. Involvement of the skull base and cervical spine is indistinguishable from an aggressive infection or a malignant tumor and can be fatal as in our case report. The difficulties in establishing clinicopathologic diagnosis, radiological imaging characteristics, and treatment are discussed.     

Appendiceal inflammatory myofibroblastic tumor: a rare postoperative finding

Inflammatory myofibroblastic tumor (IMT) is a rare soft-tissue neoplasm of unknown etiology. It mimics, clinically and radiologically, malignant tumors. Histologically, this tumor is composed of differentiated myofibroblastic spindle cells accompanied by an inflammatory infiltrate, with numerous plasma cells and/or lymphocytes. Initially described in the lung, numerous extrapulmonary sites of this tumor have been found but appendiceal IMT is rare, especially in adult women. In this study, we aimed to examine the literature as well as to describe a case of a 42-year-old woman that we operated on that presented as an appendiceal mass that obstructed the lumen of the appendix and caused acute appendicitis. Upon histopathological examination, the lesion was identified as an IMT. Awareness of this type of tumor in the differential diagnosis of appendiceal masses, avoids overtreatment, and highlights the need of long-term follow-up regarding the tendency for local recurrence and small risk of distant metastasis.     

Inflammatory Myofibroblastic Tumor of the Kidney in a Child: Report of a Case

Inflammatory myofibroblastic tumor (IMT), also known as inflammatory pseudotumor, is an uncommon benign tumor that has been reported in various locations throughout the body, but rarely in the kidney. To our knowledge, only 22 cases of renal IMT have been described in the literature. Renal IMT in children is difficult to differentiate from a malignancy such as Wilms' tumor. We report a case of a 9-year old girl with a left renal mass mimicking malignancy on preoperative diagnostic images, which was pathologically revealed to be an IMT. We review the literature and discuss the pathophysiology and clinical features of this unusual tumor.     

Pulmonary inflammatory myofibroblastic tumor associated with nephrotic syndrome

Inflammatory myofibroblastic tumor (IMT) of the lung is a benign, non-metastasizing tumor with the possibility of local infiltration, recurrence or persistent local growth. This kind of tumor arises due to an unregulated growth of inflammatory cells. To our knowledge, IMT associated with nephrotic syndrome has not yet been recognized. Therefore, we present the case of a 14-year-old girl with lung IMT associated with secondary nephrotic syndrome (NS), which was cured after tumor removal.     

中国近25年脾脏炎性肌纤维母细胞瘤的流行病学特征及诊治经验

目的：探讨中国近25年来脾脏炎性肌纤维母细胞瘤（SIMT）的流行病学特征及诊治经验。方法：联合检索中国知网、维普等多家中文数据库获取国内近25年有关SIMT的病例资料进行回顾性分析。结果：本组64例中,男39例,女25例,男女比例1.56：1。年龄24～74岁,平均49.2岁。多为查体时B超或CT发现,部分表现为上腹部不适、乏力、低热等非特异性症状。影像学检查提示脾内单发或多发,界限多清楚占位性病变。有明确病理结果描述者43例：少细胞纤维型26例,黏液样/血管型12例,丰富梭形细胞型5例;免疫组化示多数病例梭形细胞对Vimentin、SMA等抗体阳性。治疗方式主要为脾脏切除,随访无复发及转移。结论：SIMT极为罕见,临床表现无特异性,通过影像学检查、病理组织学特点及免疫组化结果可与其他脾脏占位性病变相鉴别,术前诊断较为困难,治疗主要为脾切除术,预后良好。     

Inflammatory pseudotumor of the kidney: A case report

Inflammatory pseudotumor of the kidney is a very rare lesion. We report a patient who had a renal mass raising the suspicion of a malignant neoplasm and the pathologic examination revealed an inflammatory pseudotumor. Despite its rarity, inflammatory pseudotumor of kidney should be kept in mind in the differential diagnosis of a solitary renal mass.     

Seudotumor inflamatorio y tumor miofibroblástico inflamatorio. Criterios diagnósticos y diferencias pronósticas

IntroductionInflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT) are two very rare entities that were formerly included in the same category; however, today they are considered two different diseases due to the neoplastic origin of the IMT. Our objective is to share our experience in the management of these two types of tumors that we must take into account in the differential diagnosis of pulmonary masses or nodules.MethodsThirteen patients with a pathological diagnosis of IPT and IMT who underwent surgery between 2008 and 2019 were retrospectively studied. We recorded the pre and postoperative information of each one, as well as the survival analysis.ResultsOf the 13 patients, 8 were men and 5 women. The mean age of presentation was 53,5 years. An atypical segmentectomy was performed in 6 patients; a lobectomy was necessary in 6 and a pneumonectomy in 1 case. In all cases a complete resection was achieved. Diagnosis was possible thanks to histology, immunohistochemical (IHQ) and fluorescent in situ hybridization (FISH) techniques determining the expression of IgG4 and the rearrangement of ALK, respectively. After a median follow up of 49 months, we didńt find any loco-regional or distant recurrence in the patients studied.ConclusionIPT and IMT are rare tumors with a very good prognostic. The diagnosis of both entities is based mainly on specific anatomopathological techniques. Surgery has, in most cases, both a diagnostic and therapeutic role.     

肝脏炎性肌纤维母细胞瘤的临床特点及治疗策略

目的 探讨肝脏炎性肌纤维母细胞瘤（HIMT）的临床特点及治疗方法。方法 回顾性分析中国人民解放军总医院第五医学中心2011年1月到2022年11月诊治的15例HIMT患者的临床资料,总结其临床特征及治疗策略。结果 15例中男11例,女4例,平均年龄（51.1±8.7）岁,有症状者8例,发热3例,合并慢性肝炎7例,术前正确诊断3例。3例患者PET/CT检查提示病灶表现为高代谢。免疫组化以Vimentin及平滑肌肌动蛋白（SMA）阳性为主。8例接受手术治疗,至今均未出现复发;7例观察治疗,其中3例病灶自发消退,3例缓慢缩小,1例病灶稳定。结论 HIMT没有特异性的临床特征,不明原因感染、创伤和自身免疫功能异常等导致的机体过度炎症反应可能是其病因,治疗策略仍以手术切除为首选,密切观察也是一种可供选择的治疗方法。对无法手术、复发或转移性HIMT患者,基因检测可能有助于全身治疗方案的选择。