51
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Tsuboi H, Inokuma S, Setoguchi K, Shuji S, Hagino N, Tanaka Y, Yoshida N, Hishima T, Kamisawa T. Inflammatory pseudotumors in multiple organs associated with elevated serum IgG4 level: recovery by only a small replacement dose of steroid. Intern Med 2008; 47:1139-42. [PMID: 18552474 DOI: 10.2169/internalmedicine.47.0887] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
A 62-year-old man developed a fever, fatigue, anorexia and arthralgia. Central hypocorticoidism and central hypothyroidism were observed, and a low serum antidiuretic hormon level without symptoms of diabetes insipidus, as well. Images showed swelling of pituitary stalk, mediastinal and hilar lymphnodes and pancreas, pulmonary infiltrates and retroperitoneal mass. Serum CRP level was 20.6 mg/dL, and IgG4 level was 292 mg/dL. Lung biopsy revealed pseudotumor containing IgG4-positive plasmacytes, and obliterative vasculitis both in arterioles and venules. These features were similar to those of reported IgG4-related autoimmune disease. However, replacement steroid therapy for hypocorticoidism brought about almost complete recovery except that diabetes insipidus got apparent. This is the first report on the efficacy of only a small dose of steroid, and on features of pituitary stalk involvement and central hypocorcicoidism.
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52
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Wen HH, Cheng KL, Hung YK, Chang PY. Inflammatory myofibroblastic tumor presenting as acute abdomen: report of one case. ACTA PAEDIATRICA TAIWANICA = TAIWAN ER KE YI XUE HUI ZA ZHI 2007; 48:337-341. [PMID: 18437969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a very rare benign tumor composed of myofibroblastic spindle cells of uncertain etiology, which can occur at any age and affect any organ system. More and more cases of IMT in children have been described in pediatric literature in recent years. However, this tumor occurring intraabdominally in children has rarely been reported in Taiwan. Here we present a 1-year-9-month-old boy who had fever and abdominal pain only for 2 days, symptoms mimicking acute abdomen. After imaging study, a huge tumor nearly 10 cm in diameter was incidentally found over the right abdomen with unknown origin and nature. After surgical removal of the tumor, IMT was confirmed by the pathological findings. It is very difficult to make an accurate preoperative diagnosis on this tumor according to past experience, so the role of pathological diagnosis with immunohistochemical study becomes important. This case illustrates that IMT should be considered as a possible cause of intra-abdominal mass in children who have fever of unknown origin.
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53
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Cornell LD, Chicano SL, Deshpande V, Collins AB, Selig MK, Lauwers GY, Barisoni L, Colvin RB. Pseudotumors due to IgG4 immune-complex tubulointerstitial nephritis associated with autoimmune pancreatocentric disease. Am J Surg Pathol 2007; 31:1586-97. [PMID: 17895762 DOI: 10.1097/pas.0b013e318059b87c] [Citation(s) in RCA: 148] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Autoimmune pancreatitis (AIP) is a mass-forming chronic fibroinflammatory condition centered on the pancreatobiliary system and characterized by predominant immunoglobulin G4 (IgG4)-positive plasma cells. Recent reports have brought to light the multiorgan involvement of this disease. We describe a series of 5 cases of tubulointerstitial nephritis (TIN) associated with AIP and characterize the clinical, pathologic, ultrastructural, and immunopathologic features of TIN. The specimens consisted of 4 biopsies and 1 nephrectomy. The average patient age was 64 years (range 45 to 78) and the male to female ratio was 4:1. All had histologic and/or clinical and radiographic evidence of AIP, mass-forming sclerosing cholangitis, or both. The clinical impression in 4 patients was a renal mass or vasculitis. Two patients had renal insufficiency. Histologic preparations revealed a dense tubulointerstitial lymphoplasmacytic infiltrate. Eosinophils were often numerous. Tubulitis and tubular injury were present, along with tubular atrophy with focally thickened tubular basement membranes (TBMs). The histologic appearance ranged from a cellular, inflammatory pattern without tubular atrophy to a striking expansive interstitial fibrosis with tubular destruction. The nephrectomy specimen demonstrated a masslike nodular pattern of inflammation with normal renal tissue elsewhere. Glomeruli were uninvolved. By immunohistochemistry or immunofluorescence, numerous plasma cells in the infiltrate were positive for IgG4. TBM granular IgG deposits, predominantly of the IgG4 subclass, were detected in 4 of 5 cases by either immunofluorescence or immunohistochemistry. By electron microscopy, corresponding amorphous electron-dense deposits were present in the TBM in these cases. This type of TIN, typically characterized by a masslike lesion consisting of a lymphoplasmacytic infiltrate with eosinophils and prominent IgG4-positive plasma cells and immune-complex deposits in the TBM, may be part of a systemic IgG4-related disease, which we term "IgG4-associated immune complex Multiorgan Autoimmune Disease" (IMAD).
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54
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Kriegl L, Guetgemann I, Zhou H. Plasma cell granuloma of the thyroid gland mimicking carcinoma: A case report and review of the literature. Pathol Res Pract 2007; 203:813-7. [PMID: 17822858 DOI: 10.1016/j.prp.2007.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2006] [Revised: 06/03/2007] [Accepted: 07/09/2007] [Indexed: 10/22/2022]
Abstract
Plasma cell granulomas (PCG) are rare tumor-like lesions consisting of sheets of polyclonal plasma cells admixed with numerous lymphocytes and other inflammatory cells surrounded by fibrous stroma. They usually appear in the lung, but involvement of diverse extrapulmonal sites has been described. PCGs occurring in the thyroid are very uncommon. Since 1981, only 11 cases have been described in the English literature. Here, we present the case of a 50-year-old Arabic man who noticed an enlargement of his thyroid gland during the previous 2 years, and he developed swallowing disturbances and a feeling of narrowness in the neck. A nearly total resection of the thyroid gland was made because of clinical suspicion of carcinoma. On histologic examination, PCG of the thyroid associated with Hashimoto's thyroiditis (HT) was diagnosed. This is the first case in which molecular pathological analyses for EBV and HHV8 DNA were made. As these were negative, distinct etiological features were suggested.
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55
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Lee RG, Weber DE, Ness AB, Wasman JK, Megerian CA. Inflammatory pseudotumor of the middle ear masquerading as Bell's palsy. Am J Otolaryngol 2007; 28:423-6. [PMID: 17980777 DOI: 10.1016/j.amjoto.2006.11.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2006] [Indexed: 11/17/2022]
Abstract
We describe the case of a 28-year-old woman who presented with an acute dense left facial paralysis. Magnetic resonance imaging demonstrated enhancement of the labyrinthine portion of the facial nerve, and Bell's palsy was the presumed initial diagnosis. After 2 months without recovery despite receiving steroid and antiviral therapy, the patient underwent further workup. Computed tomographic scan demonstrated a mass lesion adjacent to the tympanic portion of the facial nerve, and electromyography showed active denervation and prominent fibrillation potentials. Surgical excision of the tumor was performed with decompression and sparing of the facial nerve. Histologically, the tumor proved to be an inflammatory pseudotumor (IPT). At the 3-year follow-up, the patient had an improvement in her facial nerve function, progressing to a House-Brackman grade III. An IPT can masquerade as Bell's palsy with sudden complete facial paralysis. Failure to obtain even slight recovery in Bell's palsy should prompt further workup, including appropriate imaging, to assess for a mass lesion. Confusion of an IPT with a nerve-based tumor on frozen section and imaging could lead to inappropriate resection and cable grafting of the facial nerve. Therefore, the relationship between an IPT and facial nerve paralysis is vital and must be recognized for treatment and to maximize postoperative facial nerve function.
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56
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Lantz AG, Power NE, Gupta R, Grantmyre J. Inflammatory pseudotumor: a rare cause of hematuria and shock. Urology 2007; 70:372.e3-6. [PMID: 17826517 DOI: 10.1016/j.urology.2007.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2006] [Revised: 03/06/2007] [Accepted: 04/13/2007] [Indexed: 10/22/2022]
Abstract
We report the clinical, radiologic, and pathologic findings of a case of inflammatory pseudotumor in an otherwise healthy 44-year-old woman, who presented with dysuria and hematuria causing hemodynamic instability. Computed tomography revealed a 4.3-cm by 3.5-cm densely enhancing mass arising from the anterior bladder wall. Pathologic examination showed spindle-shaped cells with mild nuclear pleomorphism, rare mitotic activity, and a strong reaction to vimentin, with focal positivity to alpha-actin and S100 protein. Monokeratin, CK7, and CK20 were negative. After two transurethral resections, the patient underwent partial cystectomy.
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57
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Lee JH, Jung MK, Song CE, Yeo SW, Lee HK, Yang PS, Kim SW. Concomitant inflammatory pseudotumor of the temporal bone and lung: a case report. EAR, NOSE & THROAT JOURNAL 2007; 86:614-616. [PMID: 17990683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Inflammatory pseudotumors are histologically benign but locally destructive lesions that are usually found in the lung, although some cases of temporal bone involvement have been reported. To the best of our knowledge, no case of simultaneous involvement of the temporal bone and the lung has been previously reported in the literature. We describe such a case in a 39-year-old man. The temporal bone lesion was removed in its entirety, and the lung lesion was treated with steroid therapy. At the 2-month follow-up, the size of the lung mass on chest x-ray was significantly reduced, and at 1 year, the patient was asymptomatic.
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58
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Akatsu T, Kameyama K, Tanabe M, Endo T, Kitajima M. Epstein-Barr virus-positive inflammatory pseudotumor of the spleen with concomitant rectal cancer: a case report and review of the literature. Dig Dis Sci 2007; 52:2806-12. [PMID: 17406818 DOI: 10.1007/s10620-007-9773-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2006] [Accepted: 01/18/2007] [Indexed: 12/09/2022]
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59
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Boutarbouch M, Arkha Y, Rifi L, Derraz S, El Ouahabi A, El Khamlichi A. Intradural cervical inflammatory pseudotumor mimicking epidural hematoma in a pregnant woman: case report and review of the literature. ACTA ACUST UNITED AC 2007; 69:302-5. [PMID: 17765955 DOI: 10.1016/j.surneu.2006.12.056] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Accepted: 12/20/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND Inflammatory pseudotumors usually affect the lung and the orbit. They occur extremely rarely in the spine. We encountered a case of intradural extramedullary IPT of the cervical spine in a pregnant woman that initially presented as an epidural hematoma in MRI. CASE DESCRIPTION This is a case of a 30-year-old, HIV-negative, full-term pregnant lady presenting with 2-month history of progressive quadriparesis with rapid worsening of power in all 4 limbs for 3 days. Magnetic resonance imaging scanning revealed cervical extramedullary compressive lesion likely to be epidural bleed from its imaging characteristics. Intraoperatively, intradural extramedullary granulomatous lesion was found with dural thickening. Gross total excision was accomplished; histopathologic study assessed an IPT. The patient improved after surgery excision and is doing well at 6-month follow-up with remarkable neurological recovery. CONCLUSION Cervical intradural IPT is a very rare issue in the spine. Diagnosis can be confused with a neoplastic lesion like an "en plaque meningioma" or as epidural bleed like in the present case.
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60
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Pooja B, Bhatia P, Panda N, Vasishta RK. Recurrent inflammatory myofibroblastic tumour of the larynx: a clinicopathologic diagnostic dilemma. ACTA ACUST UNITED AC 2007; 36:E24-7. [PMID: 17711758 DOI: 10.2310/7070.2007.e0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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61
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Lee DH, Lee SH, Sung JK. Inflammatory myofibroblastic tumor on intercostal nerve presenting as paraneoplastic pemphigus with fatal pulmonary involvement. J Korean Med Sci 2007; 22:735-9. [PMID: 17728520 PMCID: PMC2693830 DOI: 10.3346/jkms.2007.22.4.735] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) are benign neoplasms that can occur at different anatomic sites with nonspecific clinical symptoms. A 48-yr-old woman presented with a 2-month history of a relapsed oral ulcer, progressive dyspnea, and a thoracic pain induced by breathing. A tumorous mass was noticed in the right costodiaphragmatic recess on chest computed tomography and magnetic resonance imaging, and the patient underwent a right costotransversectomy with excision of the tumor, which originated from the 12th intercostal nerve. Histology and immunohistochemistry showed that the tumor was an IMT of the intercostal nerve. The patient's postoperative course was not favorable; dyspnea persisted after surgery, and a progressive pulmonary compromise developed. The cause of the respiratory failure was found to be bronchiolitis obliterans, which in this case proved to be a fatal complication of paraneoplastic pemphigus associated with an IMT. This case of IMT of the spinal nerve in the paravertebral region is unique in terms of its location and presentation in combination with paraneoplastic pemphigus, which is rare. A brief review of the heterogeneous theories concerning the pathogenesis, clinicopathological features, and differential diagnosis of this disease entity is presented.
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62
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Burke A, Li L, Kling E, Kutys R, Virmani R, Miettinen M. Cardiac Inflammatory Myofibroblastic Tumor: A “Benign” Neoplasm That May Result in Syncope, Myocardial Infarction, and Sudden Death. Am J Surg Pathol 2007; 31:1115-22. [PMID: 17592279 DOI: 10.1097/pas.0b013e31802d68ff] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cardiac tumors other than myxomas are rare. We report a series of 10 intracavitary polypoid myofibroblastic proliferations in children and young adults emphasizing gross, histologic, and clinical features. There were 6 females and 4 males, with a mean age of 10 years (range 5 wk to 21 y). All lesions were endocardial-based, located in the right atrium (1), right ventricular inflow/tricuspid valve (1), right ventricular outflow (3), mitral valve (3), aortic valve/left coronary sinus (1), and left ventricular free wall (1). Symptoms included shortness of breath or dyspnea (3), syncope (2), chest pain (1), transient ischemic attacks (1), and fever with myalgias (1). All tumors were surgical resections, except 1 tumor that resulted in sudden coronary death and that was diagnosed at autopsy, and 1 tumor that embolized into the coronary artery and was treated by cardiac transplant. Two tumors, present in the aortic and mitral valves, respectively, caused cardiac ischemia. The tumors were polypoid or filiform and histologically resembled inflammatory myofibroblastic tumors of extracardiac sites, with loose spindle cell growth with sparse inflammation. Although there were frequent collagen bundles interspersed among the tumor cells, there were no large areas of dense fibrosis. Surface fibrin was present on the polypoid projections in 7 cases. Symptoms resulted from prolapse into coronary ostia or embolization, but no patient developed metastasis. Long-term follow-up in 2 patients demonstrated no evidence of disease or recurrence. Although metastatic potential was not identified, these tumors may result in serious symptoms, including myocardial infarct, syncope, and sudden death. These cardiac myofibroblastic tumors are readily distinguished from other endocardial-based cardiac tumors, including papillary fibroelastoma and myxoma, which may present clinically in the same manner.
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63
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Noun R, Zeidan S, Ghorra C, Tohme-Noun C. Malignant masquerade of the biliary confluence. Gut 2007; 56:379. [PMID: 17339247 PMCID: PMC1856810 DOI: 10.1136/gut.2006.095398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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64
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65
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Nawashiro H, Omura T, Kobayashi H. Cystic intracranial plasma cell granuloma. J Neurosurg 2006; 105:799; author reply 799-800. [PMID: 17121152 DOI: 10.3171/jns.2006.105.5.799] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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66
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Friedman AD, Maurer WG, Byrd MC, Cook JR, Lorenz RR. A Cytomegalovirus-Associated Mass Presenting With Laryngeal Obstruction. ACTA ACUST UNITED AC 2006; 132:1375-8. [PMID: 17178951 DOI: 10.1001/archotol.132.12.1375] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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67
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Abstract
Plasma cell granuloma (PCG) of the lung is a rare disease that usually presents as a pulmonary nodule or mass on incidental radiographic examination without symptoms. Although the etiology of PCG is still controversial, many findings have lent support to the lesion being a reactive inflammatory process rather than a neoplastic one. We describe a 53-yr-old male who presented with a hemoptysis and have a lung mass at the left upper lobe on chest radiograph. The lung mass was primarily diagnosed as PCG by percutaneous needle aspiration and biopsy, and the patient was treated with oral steroid because he and relatives refused the operation. However, the size of the lung mass did not change and open thoracotomy and lobectomy were done therefore. He was confirmed as having pulmonary actinomycosis with PCG after surgery. To our knowledge, this is the first report of PCG associated with actinomycosis in Korea.
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68
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Chan-Tack KM, Chengappa KS, Wolf JS, Kao GF, Reisler RB. Immune reconstitution inflammatory syndrome presenting as sinusitis with inflammatory pseudotumor in an HIV-infected patient: a case report and review of the literature. AIDS Patient Care STDS 2006; 20:823-8. [PMID: 17192147 DOI: 10.1089/apc.2006.20.823] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Immune reconstitution inflammatory syndrome (IRIS) encompasses a variety of conditions that occur among HIV-infected patients in a temporal relationship with increases in CD4 cell count as a result of highly active antiretroviral therapy (HAART). Most conditions associated with IRIS are infectious. Malignancies, such as Kaposi's sarcoma, have also been reported. We report a case of sinusitis with presumptive inflammatory pseudotumor as a manifestation of IRIS that occurred 20 weeks after the initiation of HAART.
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69
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McKinney AM, Short J, Lucato L, SantaCruz K, McKinney Z, Kim Y. Inflammatory myofibroblastic tumor of the orbit with associated enhancement of the meninges and multiple cranial nerves. AJNR Am J Neuroradiol 2006; 27:2217-20. [PMID: 17110698 PMCID: PMC7977206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Inflammatory myofibroblastic tumor (IMT), Tolosa-Hunt syndrome (THS), and idiopathic hypertrophic pachymeningitis (IHP) seem to be part of a spectrum of disorders that have diverse locations but similar histologic and imaging findings. We report a case of a 50-year-old man presenting with multiple progressive cranial nerves palsies with leptomeningeal cranial nerve enhancement on MRI (II, V1-V3, and X), orbital and infraorbital masses, prominence within the left cavernous sinus, and diffuse dural enhancement. Biopsies of the orbital lesion and infraorbital nerve revealed IMT. The patient's lesions, symptoms, and dural enhancement quickly improved with steroid administration and nearly resolved over multiple subsequent scans over the next few months. This case illustrates a rare case of pseudotumor mimicking a more aggressive appearance that would usually portend a case of malignancy. There is a potential association of IMT, THS, and IHP, which may have existed in a concomitant fashion in this patient. The case also describes the unique finding of enhancement of the cisternal segments of multiple cranial nerves (simulating leptomeningeal malignant involvement), which may be related to inflammatory perineural edema or ischemic neuropathy.
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70
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Kirby PA, Sato Y, Tannous R, Dehner LP. Calcifying fibrous pseudotumor of the myocardium. Pediatr Dev Pathol 2006; 9:384-7. [PMID: 16953676 DOI: 10.2350/06-01-0022.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Accepted: 03/03/2006] [Indexed: 11/20/2022]
Abstract
Calcifying fibrous pseudotumor is an uncommon tumor first described in 1988 as a childhood fibrous tumor with psammoma bodies. The typical pathological findings are those of a densely collagenized fibrous tumor with psammomatous and dystrophic calcification accompanied by a lymphoplasmacytic infiltrate. To date these tumors are reported in subcutaneous and deep soft tissues of the extremities and trunk, groin, scrotum, pleura, mediastinum, paratracheal region, peritoneum, neck, mesentery, omentum, serosa, lung, bone, and gallbladder. We describe a 17-year-old girl with a myocardial calcifying fibrous tumor, and we review the English literature.
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71
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Lee HW, Jang BK, Chung WJ, Park KS, Cho KB, Hwang JS, Kang YN, Kang KJ, Kwo JH. [A case of hepatic inflammatory pseudotumor developed with peripheral cholangiocarcinoma]. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2006; 48:200-4. [PMID: 17047436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Inflammatory pseudotumor is an uncommon mass which develops most frequently in the lung of young adults. It is characterized by localized fibrous proliferations with chronic inflammatory cell infiltration. Due to its rarity and similarity in radiologic appearance with malignant hepatic tumors, hepatic inflammatory pseudotumor (HIPT) is often misdiagnosed and resected accidentally. We report a case of HIPT which was unnecessarily resected due to synchronous small peripheral cholangiocarcinoma located on the other segment of liver.
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72
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Cole B, Zhou H, McAllister N, Afify Z, Coffin CM. Inflammatory myofibroblastic tumor with thrombocytosis and a unique chromosomal translocation With ALK rearrangement. Arch Pathol Lab Med 2006; 130:1042-5. [PMID: 16831032 DOI: 10.5858/2006-130-1042-imtwta] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We describe a case of inflammatory myofibroblastic tumor with an unusual constellation of clinical, pathologic, and genetic findings. A 7-year-old girl had an 11-cm abdominopelvic mass accompanied by thrombocytosis, anemia, elevated erythrocyte sedimentation rate, and elevated C-reactive protein. The inflammatory myofibroblastic tumor displayed unusual histologic features of zonal coagulative necrosis, high cellularity with a herringbone pattern, and tumor-associated osteoclast-like giant cells. The complex tumor karyotype included a translocation t(1;2)(q21; p23). Following resection, the laboratory abnormalities resolved. The patient is well and free of recurrence at 3 years following resection. This case raises interesting questions about clinical, pathologic, prognostic, and molecular genetic interrelationships in inflammatory myofibroblastic tumor.
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MESH Headings
- Abdominal Neoplasms/complications
- Abdominal Neoplasms/genetics
- Abdominal Neoplasms/pathology
- Abdominal Neoplasms/surgery
- Anaplastic Lymphoma Kinase
- Child
- Chromosomes, Human, Pair 1/genetics
- Chromosomes, Human, Pair 2/genetics
- DNA, Neoplasm/analysis
- Disease-Free Survival
- Female
- Gene Rearrangement
- Granuloma, Plasma Cell/complications
- Granuloma, Plasma Cell/genetics
- Granuloma, Plasma Cell/pathology
- Granuloma, Plasma Cell/surgery
- Humans
- In Situ Hybridization, Fluorescence
- Protein-Tyrosine Kinases/genetics
- Protein-Tyrosine Kinases/metabolism
- Receptor Protein-Tyrosine Kinases
- Thrombocytosis/complications
- Thrombocytosis/genetics
- Thrombocytosis/pathology
- Translocation, Genetic/genetics
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73
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Lee SH, Sung JK. Inflammatory pseudotumor of the spinal nerve complicated by paraneoplastic pemphigus. Case illustration. J Neurosurg Spine 2006; 4:514. [PMID: 16776366 DOI: 10.3171/spi.2006.4.6.514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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74
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Su JW, Caleb MG, Tan RS, Low AFH, Lim CH. Cardiac inflammatory myofibroblastic tumor as a rare cause of aortic regurgitation: a case report. J Thorac Cardiovasc Surg 2006; 132:150-1. [PMID: 16798316 DOI: 10.1016/j.jtcvs.2006.03.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2006] [Revised: 02/21/2006] [Accepted: 03/02/2006] [Indexed: 11/26/2022]
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75
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Sekaran A, Lakhtakia S, Pradeep R, Santosh D, Gupta R, Tandan M, Reddy DB, Rao GV, Reddy DN. Inflammatory myofibroblastic tumor of biliary tract presenting as recurrent GI bleed (with video). Gastrointest Endosc 2006; 63:1077-9. [PMID: 16733137 DOI: 10.1016/j.gie.2006.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2005] [Accepted: 01/11/2006] [Indexed: 02/08/2023]
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76
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77
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78
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Koide H, Sato K, Fukusato T, Kashiwabara K, Sunaga N, Tsuchiya T, Morino S, Sohara N, Kakizaki S, Takagi H, Mori M. Spontaneous regression of hepatic inflammatory pseudotumor with primary biliary cirrhosis: Case report and literature review. World J Gastroenterol 2006; 12:1645-8. [PMID: 16570364 PMCID: PMC4124304 DOI: 10.3748/wjg.v12.i10.1645] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatic inflammatory pseudotumor (IPT) is a rare benign non-neoplastic lesion characterized by proliferating fibrous tissue infiltrated by inflammatory cells. The exact etiology of IPT remains unclear. Although the association of IPT with systemic inflammatory disorders has been well established, a specific relationship with cholangitis is distinctly rare. We report a case of spontaneous regression of hepatic IPT with primary biliary cirrhosis (PBC). To date, only two cases of IPT with PBC have been reported. In our case, however, IPT developed during the course of improvement of cholangitis of PBC induced by effective treatment, differing from two previously reported cases. Our case indicates that the development of IPT does not also relate to the activity of cholangitis and/or hyper gamma-globulinemia, since our case was confirmed radiologically to be free of IPT when biliary enzymes and immunoglobulins were much higher than the corresponding values on admission. Comparison of our case with the two previously reported cases suggests that IPT occurring with PBC does not represent the same disease entity or be a bystander for PBC.
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79
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Pinarli FG, Mutlu B, Elli M, Dağdemir A, Tander B, Celenk C, Bek K, Aydin O. Plasma cell granuloma of the mediastinum with secondary renal amyloidosis. Pediatr Blood Cancer 2006; 46:387-8. [PMID: 16287131 DOI: 10.1002/pbc.20525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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80
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Sato K, Kubota T, Kitai R, Miyamori I. Meningeal plasma cell granuloma with relapsing polychondritis. J Neurosurg 2006; 104:143-6. [PMID: 16509158 DOI: 10.3171/jns.2006.104.1.143] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
✓ Relapsing polychondritis (RP) is a rare systemic disease characterized by recurrent inflammation of the cartilaginous structures and connective tissue. Central nervous system lesions in association with RP have occasionally been reported, but intracranial mass lesions have not been described. The authors report the first such case, in which a 51- year-old man presented with parasagittal meningeal plasma cell granuloma with RP. The mass was subtotally resected and adjuvant radiotherapy was administered. The patient did not experience any recurrence of the lesion during an 8-year follow-up period. In this case, the exact diagnosis of RP was made based on symptoms of respiratory tract chondritis, which was successfully treated by the placement of tracheobronchial stents.
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81
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Martín Malagón A, López-Tomassetti Fernández E, Arteaga González I, Carrillo Pallarés A, Díaz Luis H. Inflammatory myofibroblastic tumor of the distal bile duct associated with lymphoplasmacytic sclerosing pancreatitis. Case report and review of the literature. Pancreatology 2005; 6:145-54. [PMID: 16354963 DOI: 10.1159/000090256] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) or inflammatory pseudotumor has been described in various organs such as the liver, intestinal tract, spleen, kidney, bladder, lung, peritoneum and heart. However, its appearance in the periampullary region is uncommon and has rarely been reported in the literature. It is characterized histologically by myofibroblastic cell proliferation together with a mixed inflammatory infiltrate that clinically and radiologically mimics a malignant tumor. We report a case of IMT located in the distal common bile duct of a 51-year-old woman. She underwent Whipple resection with the initial diagnosis of cholangiocarcinoma; the pathologic diagnosis of the tumor was IMT of the distal bile duct associated with lymphoplasmacytic sclerosing pancreatitis. Referring to previously reported cases, suspected diagnosis of a malignant tumor made surgical excision the primary choice for symptom relief and in order to obtain a definitive diagnosis. IMT relationship with lymphoplasmacytic sclerosing pancreatitis is discussed.
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82
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Kanno A, Satoh K, Kimura K, Masamune A, Asakura T, Unno M, Matsuno S, Moriya T, Shimosegawa T. Autoimmune pancreatitis with hepatic inflammatory pseudotumor. Pancreas 2005; 31:420-3. [PMID: 16258381 DOI: 10.1097/01.mpa.0000179732.46210.da] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We report a case of autoimmune pancreatitis (AIP) with hepatic inflammatory pseudotumor (IP). The patient was clinically diagnosed as having multiple metastatic tumors originated from cholangiocellular carcinoma as well as autoimmune pancreatitis and underwent left lobectomy of the liver. Histological examination showed a diffuse or dense lymphoplasmacytic infiltration with obliterating phlebitis but an absence of neoplastic proliferation both in the liver tumor and in the biopsy specimen of the pancreas. Abundant IgG4-positive plasma cells were seen in the lesions. This is the first case report that shows a simultaneous occurrence of hepatic IP and AIP, suggesting that these lesions appeared on the background of the recently proposed entity of IgG4-related systemic disease.
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83
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Hanna SJ, Blenke E, Sharma R, Knight LC. Laryngeal inflammatory pseudotumour: an unusual cause of airway obstruction. Int J Pediatr Otorhinolaryngol 2005; 69:1253-5. [PMID: 15876459 DOI: 10.1016/j.ijporl.2005.02.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2004] [Revised: 02/19/2005] [Accepted: 02/20/2005] [Indexed: 10/25/2022]
Abstract
We report a rare case of a laryngeal pseudotumour in a child presenting with stridor, which was treated by endoscopic laryngeal resection, without the need for a tracheostomy. A short review of the literature is also presented. Although rare, laryngeal pseudotumour should be considered as part of the differential diagnosis of stridor and upper airway obstruction in children.
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84
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Nishimura R, Teramoto N, Tanada M, Kurita A, Mogami H. Inflammatory pseudotumor of the liver associated with malignant disease: report of two cases and a review of the literature. Virchows Arch 2005; 447:660-4. [PMID: 15968548 DOI: 10.1007/s00428-005-1206-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2004] [Accepted: 12/20/2004] [Indexed: 01/17/2023]
Abstract
Two cases of inflammatory pseudotumor (IPT) of the liver associated with gastrointestinal tract cancer are reported. In addition, the etiological correlation between IPT and abscesses of the liver in cancer patients is discussed. The first patient was a 63-year-old woman who underwent distal gastrectomy and partial hepatectomy under a diagnosis of stomach cancer with liver metastasis. The second patient was a 66-year-old man who had undergone surgery for rectal cancer 6 years previously and underwent partial hepatectomy under a diagnosis of metastasis of rectal cancer to the liver. The gastric cancer was a papillary adenocarcinoma limited to the mucosa, and the rectal cancer was a moderately differentiated adenocarcinoma limited to the subserosa. The resected liver tumor in the first case measured 5.5 x 5.0 x 4.0 cm and was 2.5 x 1.9 x 1.6 cm in the second. The cut surface showed that both masses were well circumscribed and divided into lobules by fibrous tissue. They were yellowish white in color and there was no evidence of necrosis or hemorrhage. Histologically the masses consisted of fibrous areas and cellular areas, and the cellular areas consisted of fascicles of plump spindle cells mingled with varying numbers of plasma cells, lymphocytes, and histiocytes. The masses were diagnosed as IPTs. Obliterating phlebitis suggesting infection via the portal vein was seen in the adjacent liver tissue in both cases. According to previous cases reported in the literature, there are three types of cancers associated with hepatic IPT: gastrointestinal tract cancer, biliary tract cancer, and cancers that need strong systemic chemotherapy. The underlying cancer types of IPT of the liver are almost similar to those associated with pyogenic liver abscesses suggesting the etiological correlation between IPT and abscesses of the liver.
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85
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86
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Vaughan KG, Aziz A, Meza MP, Hackam DJ. Mesenteric inflammatory pseudotumor as a cause of abdominal pain in a teenager: presentation and literature review. Pediatr Surg Int 2005; 21:497-9. [PMID: 15789237 DOI: 10.1007/s00383-005-1395-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2004] [Indexed: 01/22/2023]
Abstract
Inflammatory pseudotumor (IP) is an unusual cause of chronic abdominal pain in children. The management of these lesions is complicated by controversies surrounding their appropriate classification and the numerous alternate names with which they are described. Successful treatment requires careful radiologic and pathologic evaluation to distinguish IPs from other lesions, along with complete surgical resection. We present the case of a 15-year-old boy with IP and review the literature in an attempt to simplify the description of these tumors.
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87
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Alimoglu O, Sahin M, Eryilmaz R, Turgut H, Kurtulmus N, Igci A. Inflammatory pseudotumour of the liver presenting with obstructive jaundice. Acta Chir Belg 2005; 105:309-12. [PMID: 16018527 DOI: 10.1080/00015458.2005.11679723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Inflammatory pseudotumours are rare benign tumours characterized by an inflammatory process and can occur in any system. We present a case of inflammatory pseudotumours of the liver presenting with obstructive jaundice due to a mass forming lesion in the left lobe of the liver which was treated by left hepatic lobectomy. Inflammatory pseudotumour of the liver is a benign lesion and diagnosis with an image examination is difficult. Surgical management depends on the location of the lesion. Peripheral hepatic pseudotumours may be treated with simple observation or conservative therapy. In contrast to this, those involving the porta hepatis require treatment for obstructive jaundice.
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88
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Hatsuse M, Murakami S, Haruyama H, Inaba T, Shimazaki C. Inflammatory pseudotumor of the spleen complicated by idiopathic thrombocytopenic purpura. Ann Hematol 2005; 84:619-20. [PMID: 15841410 DOI: 10.1007/s00277-005-1021-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2004] [Accepted: 02/08/2005] [Indexed: 11/26/2022]
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89
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Tröbs RB, Handrick W, Lotz I, Bankwitz C, Tannapfel A. Vertebral osteomyelitis in an infant presenting with pseudotumor and narrowing of the spinal canal. Pediatr Surg Int 2005; 21:316-9. [PMID: 15742185 DOI: 10.1007/s00383-005-1378-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2004] [Indexed: 10/25/2022]
Abstract
In an 8-week-old infant, kyphosis caused by destruction of the 7th thoracic vertebra was observed. A paraspinal mass and narrowing of the spinal canal due to vertebral osteomyelitis were present. Treatment with antibiotics and bracing was carried out with no evidence of neurologic disturbances over a follow-up period of 24 months.
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90
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Sato Y, Harada K, Nakanuma Y. Hepatic inflammatory pseudotumour related to autoimmune pancreatitis. Histopathology 2005; 45:418-9. [PMID: 15469485 DOI: 10.1111/j.1365-2559.2004.01909.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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91
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Abstract
Inflammatory myofibroblastic pseudotumors are rare solid tumors found in most soft tissue locations although mainly in the lung. Their etiology is uncertain, and they are generally considered benign although some have a potential for recurrence and dissemination. Recent studies have suggested, however, that some of these tumors are in fact neoplastic processes that harbor chromosomal aberrations similar to those seen in certain lymphomas. The authors report a case of inflammatory pseudotumor of the ureter in a child and discuss recent reports.
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92
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Sasahira N, Kawabe T, Nakamura A, Shimura K, Shimura H, Itobayashi E, Asada M, Shiratori Y, Omata M. Inflammatory pseudotumor of the liver and peripheral eosinophilia in autoimmune pancreatitis. World J Gastroenterol 2005; 11:922-5. [PMID: 15682495 PMCID: PMC4250611 DOI: 10.3748/wjg.v11.i6.922] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: Inflammatory pseudotumor (IPT) of the liver is a rare benign lesion, the etiology of which remains obscure. It is not associated with any particular diseases apart from phlebitis and Crohn’s disease.
METHODS: A middle-aged male with hepatic IPT and peripheral eosinophilia associated with autoimmune pancreatitis (AIP) was selected for this study and review of literature.
RESULTS: A 59-year-old male was admitted with obstructive jaundice, marked eosinophilia (1343/mm3) and hypergammaglobulinemia (4145 mg/dL). Imaging techniques revealed dilatation of the intrahepatic bile duct, stenosis of the common bile duct with diffuse wall thickening, gallbladder wall thickening, irregular narrowing of the pancreatic duct, and swelling of the pancreatic parenchyma. Multiple liver masses were also demonstrated and diagnosed as IPT by biopsy specimens. Six months later, the abnormal features of the biliary tree remarkably improved by the oral administration of prednisolone, and the liver masses disappeared. The swelling of the pancreatic head also improved. The peripheral eosinophil count normalized. IPT associated with AIP, as we know, has not been reported in the literature. The clinical features of the present case mimicked those of pancreatic cancer with liver metastasis. This case deserves to be documented to prevent misdiagnosis of similar cases.
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93
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Chon SH, Lee CB, Oh YH. Calcifying fibrous pseudotumor causing thoracic outlet syndrome. Eur J Cardiothorac Surg 2005; 27:353-5. [PMID: 15691700 DOI: 10.1016/j.ejcts.2004.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2004] [Revised: 11/04/2004] [Accepted: 11/08/2004] [Indexed: 11/23/2022] Open
Abstract
Calcifying fibrous pseudotumor (CFP) is a relatively rare benign mass lesion that generally involves the soft tissues. We report a case of CFP occurring in an extremely rare location. The patient is a 34-year-old woman presenting symptoms of numbness of her right upper extremity caused by a CFP in her thoracic outlet and we discuss its clinical significance with a review of the literature.
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94
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95
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Hsieh YJ, Lin KY, Cheng HL, Chen TJ, Chiou YY. Inflammatory pseudotumor of the bladder: a rare cause of hematuria with impending shock in a child. ACTA PAEDIATRICA TAIWANICA = TAIWAN ER KE YI XUE HUI ZA ZHI 2004; 45:350-3. [PMID: 15868853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Hematuria is one of the most common disorders in children. Bladder tumors are rare in children, and inflammatory pseudotumor (IP) is especially rare. We report a case of inflammatory pseudotumor of the bladder in a 13-year-old girl manifested as acute onset of non-traumatic and painless gross hematuria with impending hypovolemic shock. A huge intravesicular mass (6.5 x 3.8 cm) was noted on renal-bladder ultrasound, cystoscopy, and computed tomography. Partial cystectomy was performed to remove the mass. Pathology led to a diagnosis of leiomyoma and subsequent confirmation as an IP. To our knowledge, our case is the first presentation of bladder IP in Taiwan among the reported pediatric cases.
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96
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Zen Y, Harada K, Sasaki M, Sato Y, Tsuneyama K, Haratake J, Kurumaya H, Katayanagi K, Masuda S, Niwa H, Morimoto H, Miwa A, Uchiyama A, Portmann BC, Nakanuma Y. IgG4-related sclerosing cholangitis with and without hepatic inflammatory pseudotumor, and sclerosing pancreatitis-associated sclerosing cholangitis: do they belong to a spectrum of sclerosing pancreatitis? Am J Surg Pathol 2004; 28:1193-203. [PMID: 15316319 DOI: 10.1097/01.pas.0000136449.37936.6c] [Citation(s) in RCA: 441] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Sclerosing cholangitis (SC) is a heterogeneous disease entity. Different etiologies such as choledocholithiasis, biliary tumor, or pericholangitis can manifest as SC. Hepatic inflammatory pseudotumor (IP) is rarely associated with SC (sclerosing cholangitis associated with hepatic inflammatory pseudotumor; SC-hepatic IP), but sclerosing pancreatitis (SP) is not infrequently associated with bile duct lesions (sclerosing pancreatitis-associated sclerosing cholangitis; SP-SC). In this study, we compared the histologic changes of hepatic hilar and extrahepatic bile duct lesions of SC (7 cases), SC-hepatic IP (5 cases), SP-SC (5 cases), and typical primary sclerosing cholangitis (PSC) (5 cases). Histologically, all SP-SC cases showed extensive and dense fibrosis with marked lymphoplasmacytic infiltration, many eosinophils, and obliterative phlebitis. Four cases of SC showed bile duct lesions similar to those of SP-SC, whereas other three cases of SC showed milder lymphoplasmacytic infiltration, scant eosinophilic cell infiltration, and no obliterative phlebitis. All SC-hepatic IP cases showed bile duct lesions identical to those of SP-SC. Immunohistochemically, many IgG4-positive plasma cells were found in the bile duct lesions of all SP-SC cases, 4 SC cases with marked lymphoplasmacytic infiltration, and all SC-hepatic IP cases. By contrast, IgG4-positive plasma cells were scarce or hardly found in the remaining 3 SC cases and all PSC cases. In conclusion, 4 SC cases and all SC-hepatic IP cases showed bile duct lesions identical to those of SP-SC, suggesting that these three conditions may be a single disease entity. Their pathogenesis may be similar or closely related to that of SP, and in that respect they may represent an IgG4-related biliary disease. They may respond to steroid therapy as SP does.
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97
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Browne M, Abramson LP, Chou PM, Acton R, Holinger LD, Reynolds M. Inflammatory myofibroblastic tumor (inflammatory pseudotumor) of the neck infiltrating the trachea. J Pediatr Surg 2004; 39:e1-4. [PMID: 15486877 DOI: 10.1016/j.jpedsurg.2004.06.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT), popularly known as inflammatory pseudotumor, is a slow growing quasi-neoplastic lesion with a distinct histologic appearance and benign clinical course. A case of a neck IMT with infiltration into the trachea causing asthmalike symptoms in a 12-year-old girl is described. Both tracheal and neck IMT have been described, but no other case has displayed this infiltration. A review of the pertinent literature and the etiology, diagnosis, treatment, and outcomes of this tumor are discussed. It is important to consider IMT in a differential diagnosis because it can be easily misdiagnosed as a malignancy. A surgeon must not perform radical surgery, radiation, or chemotherapy until a final pathologic diagnosis is made because of the nature of this lesion.
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98
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Abstract
Inflammatory pseudotumor (IPT) of the liver is a rare, benign lesion that is characterized by proliferating fibrous tissue infiltrated by inflammatory cells. The exact etiology of IPT remains unclear. Although the association of IPT with systemic inflammatory disorders has been established, a specific link with Crohn's disease is rare. We report two cases of IPT associated with Crohn's disease. Both patients were elderly males who presented with abdominal pain and jaundice. At the time of presentation, both had active Crohn's disease that was undiagnosed. Computed tomography demonstrated a liver mass, and endoscopic retrograde cholangiography revealed biliary strictures in both patients. Given their symptomatic jaundice and concern for cholangiocarcinoma, they underwent abdominal surgical exploration and pathology results revealed IPT. They were subsequently diagnosed with Crohn's disease. Following treatment of Crohn's disease, there was significant improvement in their overall clinical status. An underlying diagnosis of inflammatory bowel disease should be considered in patients with IPT.
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99
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Abstract
Inflammatory pseudotumour (IP) of the heart is an extremely uncommon and potentially fatal lesion which presents a challenging diagnosis even for the experienced pathologist, cardiologist and cardiac surgeon. This spindle cell tumour is known to be present in virtually every anatomical region but, in adults, has only previously been found in the heart at postmortem. We report the case of a 27-year-old man who presented with ventricular tachyarrhythmias and a right ventricular mass which was subsequently shown to be an IP.
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100
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Erkan N, Yildirim M, Yilmaz C, Yagci A. Inflammatory pseudo-tumour as an unusual cause of colonic obstruction: a case report. Acta Chir Belg 2004; 104:462-4. [PMID: 15469165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Inflammatory pseudo-tumour (IPT), also known as inflammatory myofibroblastic tumour or plasma cell granuloma, is a benign inflammatory solid tumour that may mimic malignancy. The etiology is obscure. Lung, spleen and mesentery are common sites of involvement. Colonic occurence is rare. Herein we report a case of IPT arising from the hepatic flexura with regard to its radiological, operative and histologic findings, that lead to colonic obstruction.
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