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 (common), leiomyoma/schwannoma-like areas - with nuclear palisading
| Subtypes  =
| LMDDx      = [[inflammatory myofibroblastic tumour]], [[GIST]], [[schwannoma]]
| Stains    =
| IHC        = CD34 +ve, vimentin +ve, CD117 -ve, S-100 -ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[stomach]], other places in the GI tract
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence =
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = good - benign
| Other      =
| ClinDDx    =
}}
'''Inflammatory fibroid polyp''' is an uncommon [[gastrointestinal polyp]].
 
==General==
*Benign.
*Through-out GI tract.
*Can be thought of as granulation tissue-like.<ref name=Ref_DCHH138/>
 
==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.
 
DDx:
*[[Inflammatory myofibroblastic tumour]].
*[[GIST]] - usually sharply demarcated border.
 
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>
 
===Images===
<gallery>
Image:Inflammatory_fibroid_polyp_-_low_mag.jpg | IFP - low mag. (WC)
Image:Inflammatory_fibroid_polyp_-_high_mag.jpg | IFP - high mag. (WC)
</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.
 
==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]].
 
==References==
{{Reflist|2}}


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

Revision as of 12:34, 12 July 2013

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 (common), leiomyoma/schwannoma-like areas - with nuclear palisading
LM DDx inflammatory myofibroblastic tumour, GIST, schwannoma
IHC CD34 +ve, vimentin +ve, CD117 -ve, S-100 -ve
Site stomach, other places in the GI tract
Prognosis good - benign

Inflammatory fibroid polyp is an uncommon gastrointestinal polyp.

General

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

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.

DDx:

Notes:

  • Concentric = share the same centre.[4]

Images

  • IFP - low mag. (WC)

  • IFP - high mag. (WC)

IHC

Features:[2]

  • CD34 +ve.
    • There is a CD34 -ve variant.
  • Vimentin +ve -- diffuse.[5]

Others:

  • CD117 -ve.[6]
  • S100 -ve.

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. ↑ URL: http://dictionary.reference.com/browse/concentric. Accessed on: 29 November 2011.
  5. ↑ 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.
  6. ↑ 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.
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