Difference between revisions of "Inflammatory myofibroblastic tumour"
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'''Inflammatory myofibroblastic tumour''' is an uncommon [[soft tissue lesion]]. | |||
It is also known as '''inflammatory pseudotumour''', and '''inflammatory fibrosarcoma'''<ref name=Ref_WMSP610>{{Ref WMSP|610}}</ref> and '''plasma cell granuloma'''.<ref>URL: [http://www.uptodate.com/contents/inflammatory-myofibroblastic-tumor-plasma-cell-granuloma-of-the-lung http://www.uptodate.com/contents/inflammatory-myofibroblastic-tumor-plasma-cell-granuloma-of-the-lung]. Accessed on: 27 November 2011.</ref><ref name=pmid21772725>{{Cite journal | last1 = Manohar | first1 = B. | last2 = Bhuvaneshwari | first2 = S. | title = Plasma cell granuloma of gingiva. | journal = J Indian Soc Periodontol | volume = 15 | issue = 1 | pages = 64-6 | month = Jan | year = 2011 | doi = 10.4103/0972-124X.82275 | PMID = 21772725 }}</ref> | |||
==General== | |||
*Mostly benign. | |||
*Children & young adults. | |||
*Classically located in mesentery of ileocolic region or small bowel.<ref name=Ref_WMSP610>{{Ref WMSP|610}}</ref> | |||
==Microscopic== | |||
Features:<ref name=Ref_WMSP610>{{Ref WMSP|610}}</ref> | |||
*Inflammation: | |||
**[[Plasma cells]] - predominant - '''key feature'''.<ref name=pmid21297584>{{Cite journal | last1 = Saab | first1 = ST. | last2 = Hornick | first2 = JL. | last3 = Fletcher | first3 = CD. | last4 = Olson | first4 = SJ. | last5 = Coffin | first5 = CM. | title = IgG4 plasma cells in inflammatory myofibroblastic tumor: inflammatory marker or pathogenic link? | journal = Mod Pathol | volume = 24 | issue = 4 | pages = 606-12 | month = Apr | year = 2011 | doi = 10.1038/modpathol.2010.226 | PMID = 21297584 }}</ref> | |||
**Lymphocytes. | |||
**Eosinophils. | |||
*Spindle cells without atypia. | |||
*+/-Fasciular architecture. | |||
*Mitoses -- though none atypical. | |||
*+/-Necrosis. | |||
*+/-Hemorrhage. | |||
*Calcifications. | |||
DDx: | |||
*[[Calcifying fibrous pseudotumour]] (has [[psammoma body|psammomatous calcifications]]). | |||
*[[Inflammatory fibroid tumour]]. | |||
*[[Nodular fasciitis]]. | |||
Notes: | |||
*Some consider this a wastebasket diagnosis... for benign appearing spindle cell lesions.<ref>URL: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970283-2 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970283-2]. Accessed on: 10 May 2011.</ref> | |||
===Images=== | |||
*[http://commons.wikimedia.org/wiki/File:Inflammatory_myofibroblastic_tumour_-_high_mag.jpg IMT - high mag. (WC)]. | |||
*[http://commons.wikimedia.org/wiki/File:Inflammatory_myofibroblastic_tumour_-_very_high_mag.jpg IMT - very high mag. (WC)]. | |||
==IHC== | |||
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 }} | |||
</ref> | |||
*Vimentin +ve. | |||
Variable staining with: | |||
*CD34, AE1/AE3, calretinin.<ref name=pmid20216379>{{Cite journal | last1 = Miyamoto | first1 = H. | last2 = Montgomery | first2 = EA. | last3 = Epstein | first3 = JI. | title = Paratesticular fibrous pseudotumor: a morphologic and immunohistochemical study of 13 cases. | journal = Am J Surg Pathol | volume = 34 | issue = 4 | pages = 569-74 | month = Apr | year = 2010 | doi = 10.1097/PAS.0b013e3181d438cb | PMID = 20216379 }}</ref><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> | |||
Negative:<ref name=pmid20350216/> | |||
*S100, CD117, CD68. | |||
Others: | |||
*ALK-1 +ve. ??? | |||
==Molecular== | |||
*ALK rearrangements.<ref name=pmid21297584/> | |||
==See also== | |||
*[[Soft tissue lesions]]. | |||
*[[Fibroblastic/myofibroblastic tumours]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Soft tissue lesions]] | |||
[[Category:Fibroblastic/myofibroblastic tumours]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
Revision as of 04:34, 13 August 2014
Inflammatory myofibroblastic tumour 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.
- Classically located in mesentery of ileocolic region or small bowel.[1]
Microscopic
Features:[1]
- Inflammation:
- Plasma cells - predominant - key feature.[4]
- Lymphocytes.
- Eosinophils.
- Spindle cells without atypia.
- +/-Fasciular architecture.
- Mitoses -- though none atypical.
- +/-Necrosis.
- +/-Hemorrhage.
- Calcifications.
DDx:
- Calcifying fibrous pseudotumour (has psammomatous calcifications).
- Inflammatory fibroid tumour.
- Nodular fasciitis.
Notes:
- Some consider this a wastebasket diagnosis... for benign appearing spindle cell lesions.[5]
Images
IHC
Features - dependent on site:
- SMA +ve.[6]
- Vimentin +ve.
Variable staining with:
Negative:[6]
- S100, CD117, CD68.
Others:
- ALK-1 +ve. ???
Molecular
- ALK rearrangements.[4]
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 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.
- ↑ URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970283-2. Accessed on: 10 May 2011.
- ↑ 6.0 6.1 6.2 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.
Cite error: Invalid
<ref>tag; name "pmid20350216" defined multiple times with different content - ↑ 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.