Difference between revisions of "Inflammatory myofibroblastic tumour"
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==IHC== | ==IHC== | ||
Features - dependent on site: | Features - dependent on site: | ||
*SMA +ve.<ref name=pmid20350216 >{{Cite journal | last1 = Shi | first1 = H. | last2 = Li | first2 = Y. | last3 = Wei | first3 = L. | last4 = Sun | first4 = L. | title = Primary colorectal inflammatory myofibroblastic tumour: a clinicopathological and immunohistochemical study of seven cases. | journal = Pathology | volume = 42 | issue = 3 | pages = 235-41 | month = Apr | year = 2010 | doi = 10.3109/00313021003631312 | PMID = 20350216 }} | *SMA +ve.<ref name=pmid20350216>{{Cite journal | last1 = Shi | first1 = H. | last2 = Li | first2 = Y. | last3 = Wei | first3 = L. | last4 = Sun | first4 = L. | title = Primary colorectal inflammatory myofibroblastic tumour: a clinicopathological and immunohistochemical study of seven cases. | journal = Pathology | volume = 42 | issue = 3 | pages = 235-41 | month = Apr | year = 2010 | doi = 10.3109/00313021003631312 | PMID = 20350216 }}</ref> | ||
</ref> | |||
*Vimentin +ve. | *Vimentin +ve. | ||
*ALK-1 +ve.<ref name=pmid15577680>{{Cite journal | last1 = Tsuzuki | first1 = T. | last2 = Magi-Galluzzi | first2 = C. | last3 = Epstein | first3 = JI. | title = ALK-1 expression in inflammatory myofibroblastic tumor of the urinary bladder. | journal = Am J Surg Pathol | volume = 28 | issue = 12 | pages = 1609-14 | month = Dec | year = 2004 | doi = | PMID = 15577680 }}</ref> | *ALK-1 +ve.<ref name=pmid15577680>{{Cite journal | last1 = Tsuzuki | first1 = T. | last2 = Magi-Galluzzi | first2 = C. | last3 = Epstein | first3 = JI. | title = ALK-1 expression in inflammatory myofibroblastic tumor of the urinary bladder. | journal = Am J Surg Pathol | volume = 28 | issue = 12 | pages = 1609-14 | month = Dec | year = 2004 | doi = | PMID = 15577680 }}</ref> | ||
Revision as of 02:50, 8 March 2017
| Inflammatory myofibroblastic tumour | |
|---|---|
| Diagnosis in short | |
 Inflammatory myofibroblastic tumour. H&E stain. | |
|
| |
| LM | inflammation (plasma cells - predominant, lymphocytes, eosinophils), spindle cells without atypia +/-fascicular architecture, +/-mitoses (none atypical), +/-necrosis, +/-hemorrhage, +/-calcification |
| LM DDx | calcifying fibrous pseudotumour, inflammatory fibroid tumour, nodular fasciitis, gastrointestinal stromal tumour |
| Site | soft tissue - see fibroblastic/myofibroblastic tumours |
|
| |
| Prevalence | uncommon |
| Prognosis | benign |
| Clin. DDx | other soft tissue lesions |
Inflammatory myofibroblastic tumour, abbreviated IMT, is an uncommon soft tissue lesion.
It is also known as inflammatory pseudotumour, and inflammatory fibrosarcoma[1] and plasma cell granuloma.[2][3]
General
- Mostly benign.
- Children & young adults.
Gross
- Classically located in mesentery of ileocolic region or small bowel.[1]
- May be seen in the urinary bladder.[4]
Microscopic
Features:[1]
- Inflammation:
- Plasma cells - predominant - key feature.[5]
- Lymphocytes.
- Eosinophils.
- Spindle cells without atypia.
- +/-Fascicular architecture.
- Mitoses -- though none atypical.
- +/-Necrosis.
- +/-Hemorrhage.
- Calcifications.
DDx:
- Calcifying fibrous pseudotumour (has psammomatous calcifications).
- Inflammatory fibroid tumour.
- Nodular fasciitis.
- Gastrointestinal stromal tumour.[6]
- IgG4-related systemic disease.[5]
Notes:
- Some consider this a wastebasket diagnosis... for benign appearing spindle cell lesions.[7]
Images
IMT - high mag. (WC)
IMT - very high mag. (WC)
IHC
Features - dependent on site:
Variable staining with:
Negative:[8]
- S100, CD117, CD68.
Molecular
- ALK rearrangements.[5]
See also
References
- ↑ 1.0 1.1 1.2 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 610. ISBN 978-0781765275.
- ↑ URL: http://www.uptodate.com/contents/inflammatory-myofibroblastic-tumor-plasma-cell-granuloma-of-the-lung. Accessed on: 27 November 2011.
- ↑ Manohar, B.; Bhuvaneshwari, S. (Jan 2011). "Plasma cell granuloma of gingiva.". J Indian Soc Periodontol 15 (1): 64-6. doi:10.4103/0972-124X.82275. PMID 21772725.
- ↑ 4.0 4.1 Tsuzuki, T.; Magi-Galluzzi, C.; Epstein, JI. (Dec 2004). "ALK-1 expression in inflammatory myofibroblastic tumor of the urinary bladder.". Am J Surg Pathol 28 (12): 1609-14. PMID 15577680.
- ↑ 5.0 5.1 5.2 Saab, ST.; Hornick, JL.; Fletcher, CD.; Olson, SJ.; Coffin, CM. (Apr 2011). "IgG4 plasma cells in inflammatory myofibroblastic tumor: inflammatory marker or pathogenic link?". Mod Pathol 24 (4): 606-12. doi:10.1038/modpathol.2010.226. PMID 21297584.
- ↑ 6.0 6.1 Kataoka, TR.; Yamashita, N.; Furuhata, A.; Hirata, M.; Ishida, T.; Nakamura, I.; Hirota, S.; Haga, H. et al. (2014). "An inflammatory myofibroblastic tumor exhibiting immunoreactivity to KIT: a case report focusing on a diagnostic pitfall.". World J Surg Oncol 12: 186. doi:10.1186/1477-7819-12-186. PMID 24938355.
- ↑ URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970283-2. Accessed on: 10 May 2011.
- ↑ 8.0 8.1 8.2 Shi, H.; Li, Y.; Wei, L.; Sun, L. (Apr 2010). "Primary colorectal inflammatory myofibroblastic tumour: a clinicopathological and immunohistochemical study of seven cases.". Pathology 42 (3): 235-41. doi:10.3109/00313021003631312. PMID 20350216.
- ↑ Miyamoto, H.; Montgomery, EA.; Epstein, JI. (Apr 2010). "Paratesticular fibrous pseudotumor: a morphologic and immunohistochemical study of 13 cases.". Am J Surg Pathol 34 (4): 569-74. doi:10.1097/PAS.0b013e3181d438cb. PMID 20216379.