Difference between revisions of "Inflammatory myofibroblastic tumour"
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'''Inflammatory myofibroblastic tumour''' is an uncommon [[soft tissue lesion]]. | '''Inflammatory myofibroblastic tumour''', abbreviated '''IMT''', 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> | 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> | ||
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*[[Inflammatory fibroid tumour]]. | *[[Inflammatory fibroid tumour]]. | ||
*[[Nodular fasciitis]]. | *[[Nodular fasciitis]]. | ||
*[[Gastrointestinal stromal tumour]].<ref name=pmid24938355>{{Cite journal | last1 = Kataoka | first1 = TR. | last2 = Yamashita | first2 = N. | last3 = Furuhata | first3 = A. | last4 = Hirata | first4 = M. | last5 = Ishida | first5 = T. | last6 = Nakamura | first6 = I. | last7 = Hirota | first7 = S. | last8 = Haga | first8 = H. | last9 = Katsuyama | first9 = E. | title = An inflammatory myofibroblastic tumor exhibiting immunoreactivity to KIT: a case report focusing on a diagnostic pitfall. | journal = World J Surg Oncol | volume = 12 | issue = | pages = 186 | month = | year = 2014 | doi = 10.1186/1477-7819-12-186 | PMID = 24938355 }}</ref> | |||
Notes: | Notes: | ||
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*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> | ||
*CD117 -ve. | |||
**Case report of CD117 +ve.<ref name=pmid24938355/> | |||
Variable staining with: | Variable staining with: | ||
Revision as of 05:24, 13 August 2014
| 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 |
| 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]
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 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.
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.