Difference between revisions of "Inflammatory fibroid polyp"

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#redirect [[Stomach#Inflammatory_fibroid_polyp]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Inflammatory_fibroid_polyp_-_low_mag.jpg
| Width      =
| Caption    = Inflammatory fibroid polyp. [[H&E stain]].
| Micro      = proliferating spindle cells - loosely arranged round blood vessels with perivascular hypocellular zones, eosinophils (usually prominent), +/-leiomyoma/schwannoma-like areas - with nuclear palisading
| Subtypes  =
| LMDDx      = [[inflammatory myofibroblastic tumour]], [[GIST]], [[hemangiopericytoma]], [[eosinophilic gastritis]], [[schwannoma]]
| Stains    =
| IHC        = CD34 +ve, vimentin +ve, CD117 -ve, S-100 -ve
| EM        =
| Molecular  = +/-PDGFRA mutations
| IF        =
| Gross      =
| Grossing  =
| Site      = [[stomach]], other places in the GI tract
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = good - benign
| Other      =
| ClinDDx    =
}}
'''Inflammatory fibroid polyp''', abbreviated '''IFP''', is an uncommon [[gastrointestinal polyp]].
 
==General==
*Benign.
*Through-out GI tract.
*Can be thought of as granulation tissue-like.<ref name=Ref_DCHH138/>
*Uncommon.
 
==Microscopic==
Features:<ref name=pmid20393746>{{Cite journal  | last1 = Daum | first1 = O. | last2 = Hatlova | first2 = J. | last3 = Mandys | first3 = V. | last4 = Grossmann | first4 = P. | last5 = Mukensnabl | first5 = P. | last6 = Benes | first6 = Z. | last7 = Michal | first7 = M. | title = Comparison of morphological, immunohistochemical, and molecular genetic features of inflammatory fibroid polyps (Vanek's tumors). | journal = Virchows Arch | volume = 456 | issue = 5 | pages = 491-7 | month = May | year = 2010 | doi = 10.1007/s00428-010-0914-8 | PMID = 20393746 }}</ref>
*Proliferating spindle cells (fibroid) - '''key feature'''.
**Loosely arranged, concentrically, around blood vessels.<ref name=Ref_GLP115>{{Ref GLP|115}}</ref>
**Perivascular hypocellular zones.<ref name=Ref_DCHH138>{{Ref DCHH|138}}</ref>
*Inflammation:
**Eosinophils - often prominent.
*+/-Leiomyoma/schwannoma-like areas - with nuclear palisading.<ref name=Ref_DCHH138>{{Ref DCHH|138}}</ref>
*+/-Vascular for fibrous tissue.
*Poorly circumscribed/infiltrates into the lamina propria.
*+/-Myxoid stroma.<ref name=pmid24764778>{{Cite journal  | last1 = Islam | first1 = RS. | last2 = Patel | first2 = NC. | last3 = Lam-Himlin | first3 = D. | last4 = Nguyen | first4 = CC. | title = Gastric polyps: a review of clinical, endoscopic, and histopathologic features and management decisions. | journal = Gastroenterol Hepatol (N Y) | volume = 9 | issue = 10 | pages = 640-51 | month = Oct | year = 2013 | doi =  | PMID = 24764778 }}</ref>
 
Notes:
*Concentric = share the same centre.<ref>URL: [http://dictionary.reference.com/browse/concentric http://dictionary.reference.com/browse/concentric]. Accessed on: 29 November 2011.</ref>
 
DDx:<ref name=pmid22759473>{{Cite journal  | last1 = Rossi | first1 = P. | last2 = Montuori | first2 = M. | last3 = Balassone | first3 = V. | last4 = Ricciardi | first4 = E. | last5 = Anemona | first5 = L. | last6 = Manzelli | first6 = A. | last7 = Petrella | first7 = G. | title = Inflammatory fibroid polyp. A case report and review of the literature. | journal = Ann Ital Chir | volume = 83 | issue = 4 | pages = 347-51 | month =  | year =  | doi =  | PMID = 22759473 }}</ref>
*[[Inflammatory myofibroblastic tumour]].
*[[GIST]] - usually sharply demarcated border.
*[[Hemangiopericytoma]].
*[[Eosinophilic gastritis]].
 
===Images===
<gallery>
Image: Inflammatory fibroid polyp - low mag.jpg | Low mag.
Image: Inflammatory fibroid polyp - intermed mag.jpg | Intermed. mag.
Image: Inflammatory fibroid polyp - 2 - high mag.jpg | High mag.
Image: Inflammatory fibroid polyp - high mag.jpg | High mag.
Image: Inflammatory fibroid polyp - very high mag.jpg | Very high mag.
</gallery>
 
==IHC==
Features:<ref name=pmid20393746/>
*CD34 +ve.
**There is a CD34 -ve variant.
*Vimentin +ve -- diffuse.<ref>{{Cite journal  | last1 = Kolodziejczyk | first1 = P. | last2 = Yao | first2 = T. | last3 = Tsuneyoshi | first3 = M. | title = Inflammatory fibroid polyp of the stomach. A special reference to an immunohistochemical profile of 42 cases. | journal = Am J Surg Pathol | volume = 17 | issue = 11 | pages = 1159-68 | month = Nov | year = 1993 | doi =  | PMID = 8214261 }}</ref>
 
Others:
*CD117 -ve.<ref name=pmid15163021>{{Cite journal  | last1 = Ozolek | first1 = JA. | last2 = Sasatomi | first2 = E. | last3 = Swalsky | first3 = PA. | last4 = Rao | first4 = U. | last5 = Krasinskas | first5 = A. | last6 = Finkelstein | first6 = SD. | title = Inflammatory fibroid polyps of the gastrointestinal tract: clinical, pathologic, and molecular characteristics. | journal = Appl Immunohistochem Mol Morphol | volume = 12 | issue = 1 | pages = 59-66 | month = Mar | year = 2004 | doi =  | PMID = 15163021 }}
</ref>
*S100 -ve.
*Cyclin D1 +ve.<ref name=pmid14707872>{{Cite journal  | last1 = Pantanowitz | first1 = L. | last2 = Antonioli | first2 = DA. | last3 = Pinkus | first3 = GS. | last4 = Shahsafaei | first4 = A. | last5 = Odze | first5 = RD. | title = Inflammatory fibroid polyps of the gastrointestinal tract: evidence for a dendritic cell origin. | journal = Am J Surg Pathol | volume = 28 | issue = 1 | pages = 107-14 | month = Jan | year = 2004 | doi =  | PMID = 14707872 }}</ref>
 
==Molecular==
*A subset have mutations in PDGFRA.<ref name=pmid20393746>{{Cite journal  | last1 = Daum | first1 = O. | last2 = Hatlova | first2 = J. | last3 = Mandys | first3 = V. | last4 = Grossmann | first4 = P. | last5 = Mukensnabl | first5 = P. | last6 = Benes | first6 = Z. | last7 = Michal | first7 = M. | title = Comparison of morphological, immunohistochemical, and molecular genetic features of inflammatory fibroid polyps (Vanek's tumors). | journal = Virchows Arch | volume = 456 | issue = 5 | pages = 491-7 | month = May | year = 2010 | doi = 10.1007/s00428-010-0914-8 | PMID = 20393746 }}</ref>
 
==See also==
*[[Stomach]].
*[[Gastrointestinal tract polyps]].
 
==References==
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Gastrointestinal pathology]]

Latest revision as of 18:56, 6 December 2015

Inflammatory fibroid polyp
Diagnosis in short

Inflammatory fibroid polyp. H&E stain.
LM proliferating spindle cells - loosely arranged round blood vessels with perivascular hypocellular zones, eosinophils (usually prominent), +/-leiomyoma/schwannoma-like areas - with nuclear palisading
LM DDx inflammatory myofibroblastic tumour, GIST, hemangiopericytoma, eosinophilic gastritis, schwannoma
IHC CD34 +ve, vimentin +ve, CD117 -ve, S-100 -ve
Molecular +/-PDGFRA mutations
Site stomach, other places in the GI tract
Prevalence uncommon
Prognosis good - benign

Inflammatory fibroid polyp, abbreviated IFP, is an uncommon gastrointestinal polyp.

General

  • Benign.
  • Through-out GI tract.
  • Can be thought of as granulation tissue-like.[1]
  • Uncommon.

Microscopic

Features:[2]

  • Proliferating spindle cells (fibroid) - key feature.
    • Loosely arranged, concentrically, around blood vessels.[3]
    • Perivascular hypocellular zones.[1]
  • Inflammation:
    • Eosinophils - often prominent.
  • +/-Leiomyoma/schwannoma-like areas - with nuclear palisading.[1]
  • +/-Vascular for fibrous tissue.
  • Poorly circumscribed/infiltrates into the lamina propria.
  • +/-Myxoid stroma.[4]

Notes:

  • Concentric = share the same centre.[5]

DDx:[6]

Images

  • Low mag.

  • Intermed. mag.

  • High mag.

  • High mag.

  • Very high mag.

IHC

Features:[2]

  • CD34 +ve.
    • There is a CD34 -ve variant.
  • Vimentin +ve -- diffuse.[7]

Others:

  • CD117 -ve.[8]
  • S100 -ve.
  • Cyclin D1 +ve.[9]

Molecular

  • A subset have mutations in PDGFRA.[2]

See also

References

  1. ↑ 1.0 1.1 1.2 Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 138. ISBN 978-0470519035.
  2. ↑ 2.0 2.1 2.2 Daum, O.; Hatlova, J.; Mandys, V.; Grossmann, P.; Mukensnabl, P.; Benes, Z.; Michal, M. (May 2010). "Comparison of morphological, immunohistochemical, and molecular genetic features of inflammatory fibroid polyps (Vanek's tumors).". Virchows Arch 456 (5): 491-7. doi:10.1007/s00428-010-0914-8. PMID 20393746.
  3. ↑ Iacobuzio-Donahue, Christine A.; Montgomery, Elizabeth A. (2005). Gastrointestinal and Liver Pathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 115. ISBN 978-0443066573.
  4. ↑ Islam, RS.; Patel, NC.; Lam-Himlin, D.; Nguyen, CC. (Oct 2013). "Gastric polyps: a review of clinical, endoscopic, and histopathologic features and management decisions.". Gastroenterol Hepatol (N Y) 9 (10): 640-51. PMID 24764778.
  5. ↑ URL: http://dictionary.reference.com/browse/concentric. Accessed on: 29 November 2011.
  6. ↑ Rossi, P.; Montuori, M.; Balassone, V.; Ricciardi, E.; Anemona, L.; Manzelli, A.; Petrella, G.. "Inflammatory fibroid polyp. A case report and review of the literature.". Ann Ital Chir 83 (4): 347-51. PMID 22759473.
  7. ↑ Kolodziejczyk, P.; Yao, T.; Tsuneyoshi, M. (Nov 1993). "Inflammatory fibroid polyp of the stomach. A special reference to an immunohistochemical profile of 42 cases.". Am J Surg Pathol 17 (11): 1159-68. PMID 8214261.
  8. ↑ Ozolek, JA.; Sasatomi, E.; Swalsky, PA.; Rao, U.; Krasinskas, A.; Finkelstein, SD. (Mar 2004). "Inflammatory fibroid polyps of the gastrointestinal tract: clinical, pathologic, and molecular characteristics.". Appl Immunohistochem Mol Morphol 12 (1): 59-66. PMID 15163021.
  9. ↑ Pantanowitz, L.; Antonioli, DA.; Pinkus, GS.; Shahsafaei, A.; Odze, RD. (Jan 2004). "Inflammatory fibroid polyps of the gastrointestinal tract: evidence for a dendritic cell origin.". Am J Surg Pathol 28 (1): 107-14. PMID 14707872.
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