Inflammatory fibroid polyp

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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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