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Inflammatory myofibroblastic tumour (view source)
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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]] | ||