1
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Karimi R, Adlakha A. Post-COVID-19 Pulmonary Inflammatory Pseudotumors Treated With Steroid Taper. Cureus 2024; 16:e57339. [PMID: 38690453 PMCID: PMC11059197 DOI: 10.7759/cureus.57339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/30/2024] [Indexed: 05/02/2024] Open
Abstract
The aftermath of COVID-19 continues to unveil an array of pulmonary complications, extending beyond the acute phase of the viral infection. Among these emerging sequelae, we present the case of a 58-year-old individual who developed pulmonary inflammatory pseudotumors (PIPs) following recovery from COVID-19. PIPs are exceedingly rare benign lesions that can pose a diagnostic challenge due to their clinical and radiological resemblance to malignant neoplasms. Histologically, PIPs are characterized by a proliferation of myofibroblastic spindle cells accompanied by inflammatory infiltrates, including lymphocytes, plasma cells, and histiocytes. As our understanding of post-COVID-19 complications evolves, this case serves as the first exploration into the complex interplay between COVID-19 infections and the subsequent development of inflammatory pseudotumors. In this report, an investigation is performed into the clinical presentation, diagnostic challenges, and successful management of post-COVID-19 PIPs with a focus on the pivotal role of corticosteroid therapy in mitigating the inflammatory response associated with this unique post-viral entity and resolution of the masses.
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Affiliation(s)
- Rayhan Karimi
- Internal Medicine, Edward Via College of Osteopathic Medicine, Spartanburg, USA
| | - Arun Adlakha
- Pulmonology, Carolina Lung Clinic, Piedmont Medical Center, Rock Hill, USA
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2
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Vounckx M, Jansen YJL, Fadaei S, Geers C, De Pauw V, Smets D. Unraveling the spectrum of inflammatory myofibroblastic tumors in the lung: A comprehensive case series highlighting endobronchial, pleural, and lung parenchymal tumors. JTCVS OPEN 2024; 17:297-305. [PMID: 38420532 PMCID: PMC10897672 DOI: 10.1016/j.xjon.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/14/2023] [Accepted: 12/04/2023] [Indexed: 03/02/2024]
Abstract
Objectives Diverse cases of inflammatory myofibroblastic tumors (IMTs) in the lung (pleural, endobronchial, and parenchymal) are presented while discussing the (preoperative) diagnostic challenges and treatment modalities. Other objectives include emphasizing the significance of gene rearrangements and highlighting the multidisciplinary approach in addressing IMTs. Methods Four cases of IMT in the lung are presented, including a young adolescent girl with an ETV6-neurotrophic tyrosine receptor kinase 3 (NTRK3) gene rearrangement, a 5-year-old boy with challenging preoperative diagnosis, and 2 middle-aged women with respectively pleural and endobronchial tumors with one peribronchial relapse. Results The cases demonstrate the diverse clinical presentations and diagnostic complexities associated with IMT in the lung. Surgical resection remains the primary treatment modality, with complete resection leading to a cure in most patients. Unfortunately, aggressive relapse can occur, as in our last case of an endobronchial tumor. Frozen section may confirm the presence of malignant cells perioperatively and impact further treatment. The presence of gene rearrangements, such as ETV6-NTRK3, suggests potential therapeutic implications. Conclusions Early detection and complete surgical removal of IMT are crucial for effective treatment. Identifying gene rearrangements such as ETV6-NTRK3 holds promise for targeted therapies. Diagnostic challenges, including the controversy of biopsies and preoperative evaluations, underscore the importance of a multidisciplinary approach. Anatomopathological recognition of IMT stays demanding. Close surveillance is necessary due to potential relapse, whereas frozen section perioperatively can help further treatment. This case series emphasizes the diagnostic challenges and therapeutic considerations for IMT in the lung.
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Affiliation(s)
- Manon Vounckx
- Department of Thoracic Surgery, UZ Brussel, Jette, Belgium
| | - Yanina J L Jansen
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Lung Transplant Unit, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | | | - Caroline Geers
- Department of Anatomopathology, UZ Brussel, Jette, Belgium
| | | | - Dirk Smets
- Department of Thoracic Surgery, UZ Brussel, Jette, Belgium
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3
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Durham C, Clemons M, Alias A, Konduri K. Locally Advanced Inflammatory Myofibroblastic Tumor Treated With Targeted Therapy: A Case Report and Literature Review. Cureus 2022; 14:e27223. [PMID: 36035049 PMCID: PMC9400374 DOI: 10.7759/cureus.27223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/30/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) are known to be associated with anaplastic lymphoma kinase (ALK) gene rearrangements. Other molecular alterations such as ROS proto-oncogene 1, receptor tyrosine kinase (ROS1), neurotrophic tyrosine receptor kinase (NTRK), and platelet-derived growth factor receptor (PDGFR) have also been identified in IMTs. Although there are no randomized controlled clinical trials comparing chemotherapy, tyrosine kinase inhibitors (TKIs), or other systemic therapies, the literature demonstrates the use of ALK-targeted TKIs as an effective strategy for the treatment of locally advanced or metastatic ALK-rearranged IMTs. This case report describes a patient with an ALK-rearranged locally advanced pulmonary IMT who was treated with neoadjuvant-intent crizotinib. The patient had a very favorable response to therapy, and surgery was declined. It is difficult to determine the duration and sequencing of TKI use in these settings as there is little published data to guide decisions. This report also includes a comprehensive compilation of published IMT cases with molecular alterations treated with systemic therapy, which also highlighted the duration of therapies and clinical outcomes.
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4
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Zarrouki S, Marouf R. Mini-invasive endoscopic approach to tracheal inflammatory myofibroblastic tumor in a young woman: A case report. Ann Med Surg (Lond) 2022; 73:103208. [PMID: 35070283 PMCID: PMC8767228 DOI: 10.1016/j.amsu.2021.103208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/19/2021] [Accepted: 12/19/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Inflammatory myofibroblastic tumor (IMT) of the trachea is rare tumor mostly found in children and young adults. CASE REPORT We report a case of a 28 year-old woman who presented chronic isolated coughing. Chest CT scan showed a tracheal tumor. Rigid bronchoscopy allowed the complete removal of the tumor, and histology confirmed the diagnosis of IMT. 12 months follow-up found no recurrence. DISCUSSION IMT is a rare tumor exhibiting both benign and aggressive behaviour. The endoscopic approach of tracheal should be considered when there is a minimal tracheal wall invasion. CONCLUSION Through this case, we want to emphasise the role of rigid bronchoscopy in the complete removal of endotracheal IMT.
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Affiliation(s)
- Sara Zarrouki
- Thoracic Surgery Departement, Mohammed VI University Hospital Center, Oujda, Morocco
- Mohammed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Rachid Marouf
- Thoracic Surgery Departement, Mohammed VI University Hospital Center, Oujda, Morocco
- Mohammed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
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5
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Boriçi S, Tanka M, Serbo L. Inflammatory myofibroblastic tumour of the lung: Case report and review of the literature. Respirol Case Rep 2022; 10:e0885. [PMID: 34934506 PMCID: PMC8652042 DOI: 10.1002/rcr2.885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
Inflammatory myofibroblastic tumour (IMT) of the lung is a rare tumour encountered in children. Although it is seen mostly in paediatric ages, a small number of cases exists in the literature. It may appear as an inflammatory mass or may have the characteristics of a tumour with the ability for recidivism and metastasis. Careful follow-up of the cases is required to differentiate between the two. We present the case of a 4-year-old girl who presented with cough, and the chest x-ray and computed tomography scan revealed a tumour mass in the right lung. After lobectomy, histological examination combined with immunohistochemical study discovered an IMT of the lung.
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Affiliation(s)
- Sonila Boriçi
- Service of Pulmonology and AllergyUniversity Hospital Center “Mother Tereza”TiranaAlbania
| | - Marjeta Tanka
- Service of Pulmonology and AllergyUniversity Hospital Center “Mother Tereza”TiranaAlbania
| | - Luljeta Serbo
- Service of Pulmonology and AllergyUniversity Hospital Center “Mother Tereza”TiranaAlbania
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6
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Waghchoure S, Bradley R, Sorrell M, Arya R. Successful rigid bronchoscopic resection of recurrent pulmonary inflammatory myofibroblastic tumor after complete surgical resection. Proc AMIA Symp 2019; 32:408-410. [PMID: 31384203 DOI: 10.1080/08998280.2019.1612688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 04/20/2019] [Accepted: 04/22/2019] [Indexed: 10/26/2022] Open
Abstract
Inflammatory myofibroblastic tumor, previously named inflammatory pseudotumor, is a biologically borderline mesenchymal neoplasm often associated with an inflammatory infiltrate. The incidence of inflammatory myofibroblastic tumor has been found to range from 0.04% to 1.2%, with endobronchial cases being extremely rare. The treatment of choice for pulmonary inflammatory myofibroblastic tumor is complete surgical resection. However, disease recurrence has been reported. Modalities used to treat recurrent and metastatic disease include surgical resection and corticosteroids. We present a case of recurrent endobronchial inflammatory myofibroblastic tumor that was successfully treated endoscopically with rigid bronchoscopy and laser debulking without need for further surgical intervention.
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Affiliation(s)
- Simon Waghchoure
- Department of Pulmonary and Critical Care Medicine, University of South Carolina School of MedicineColumbiaSouth Carolina
| | - Robert Bradley
- Department of Pathology, University of South Carolina School of MedicineColumbiaSouth Carolina
| | - McKenzie Sorrell
- Department of Internal Medicine, University of South Carolina School of MedicineColumbiaSouth Carolina
| | - Rohan Arya
- Department of Pulmonary and Critical Care Medicine, University of South Carolina School of MedicineColumbiaSouth Carolina
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7
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Honda K, Kadowaki S, Kato K, Hanai N, Hasegawa Y, Yatabe Y, Muro K. Durable response to the ALK inhibitor alectinib in inflammatory myofibroblastic tumor of the head and neck with a novel SQSTM1-ALK fusion: a case report. Invest New Drugs 2019; 37:791-795. [PMID: 30790150 DOI: 10.1007/s10637-019-00742-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 02/04/2019] [Indexed: 12/12/2022]
Abstract
An inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm that typically develops in the lungs and seldom in the head and neck region. It is often related to the anaplastic lymphoma kinase (ALK) fusion gene. Crizotinib, a first-generation ALK inhibitor, has been shown to have a notable response in patients with ALK-positive IMT. Here, we report the first case of a 46-year-old man with IMT harboring a novel SQSTM1-ALK fusion gene who demonstrated marked response to alectinib. The patient presented a right neck mass (5-cm diameter) that progressively enlarged and expanded to the upper mediastinum. ALK-rearranged IMT was diagnosed after complete tumor resection. Spindle cells displayed diffuse cytoplasmic staining for ALK on immunohistochemistry. A fluorescence in situ hybridization analysis revealed the translocation of a part of the ALK gene locus at chromosome 2p23. FoundationOne CDx™ assay identified an SQSTM1-ALK gene fusion. After a year, right cervical, subclavian, and mediastinal lymph node metastases, considered unresectable, developed. Notably, the patient exhibited a marked response to alectinib treatment and has sustained for 17 months following systemic therapy initiation without significant adverse events. This report highlights the possibility of alectinib being a reasonable option for advanced IMT with the SQSTM1-ALK fusion.
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Affiliation(s)
- Kazunori Honda
- Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Shigenori Kadowaki
- Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
| | - Kyoko Kato
- Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yasuhisa Hasegawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
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8
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Sagar AES, Jimenez CA, Shannon VR. Clinical and Histopathologic Correlates and Management Strategies for Inflammatory Myofibroblastic tumor of the lung. A case series and review of the literature. Med Oncol 2018; 35:102. [PMID: 29869302 DOI: 10.1007/s12032-018-1161-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 05/30/2018] [Indexed: 11/29/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a mesenchymal neoplasm that may arise in soft tissues of nearly every organ. Although IMTs are the most common lung tumors in pediatric populations, these tumors are extremely rare in adults, constituting less than 1% of adult lung tumors. IMTs are characterized by proliferating spindle cells with variable inflammatory component. The biological behavior of lung IMTs in adults is highly unpredictable, which confounds diagnosis and treatment. We retrospectively investigated patients with pulmonary lesions and the histopathologic diagnosis of inflammatory myofibroblastic tumor or its synonymous names (Plasma Cell Granuloma, xanthogranuloma, inflammatory pseudotumor, fibroxanthoma, and fibrous histiocytoma) at the MD Anderson Cancer Institute in the period between August 2000 and August 2016. We describe 7 adult cases of IMT of the lung that were diagnosed at MD Anderson Cancer Center. These cases highlight the tumor's variability in terms of clinical presentation, histopathology, and biologic behavior, and underscore the challenges in the management of these rare lung neoplasms.
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Affiliation(s)
- Ala Eddin S Sagar
- Department of Pulmonary Medicine, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA.
| | - Carlos A Jimenez
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Vickie R Shannon
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
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9
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Reddy RZ, Carter YM, Hsia DW. Pulmonary inflammatory pseudotumor causing lung collapse responding to corticosteroid therapy. Respir Med Case Rep 2018; 24:113-116. [PMID: 29977776 PMCID: PMC6010639 DOI: 10.1016/j.rmcr.2018.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/25/2018] [Accepted: 05/02/2018] [Indexed: 11/17/2022] Open
Abstract
Pulmonary inflammatory pseudotumor (PIP) is a rare benign tumor that represents less than one percent of all tumors found in the lungs. Despite the benign etiology, PIP can cause significant clinical problems due to its growth rate and potential to compromise adjacent pulmonary and thoracic structures. Complete surgical resection is the preferred therapy for PIP to prevent recurrence, however, this is not possible in some patients due to the size or location of the tumor. We present the case of an 18 year-old male presenting with PIP in the proximal left mainstem bronchus causing complete left lung collapse. Surgical resection was not possible due to tumor location, and therefore the patient was treated with corticosteroids with marked response. Corticosteroid use has for PIP has been described in few other situations, and this case demonstrates the potential for this therapeutic option in patients with PIP who have a contraindication to surgical resection.
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Affiliation(s)
- Radhika Z. Reddy
- VA Long Beach Medical Center, Department of Medicine, Division of Pulmonary and Critical Care Medicine, USA1
https://www.longbeach.va.gov/. - Corresponding author.
| | - Yvonne M. Carter
- Sinai Hospital of Baltimore, Department of Surgery, Division of Thoracic Surgery, USA2
http://www.lifebridgehealth.org/Sinai/SinaiDivisionofThoracicSurgery.aspx.
| | - David W. Hsia
- Harbor-UCLA Medical Center, Department of Medicine, Division of Respiratory and Critical Care Physiology and Medicine, USA3
http://www.harbor-ucla.org/respiratory-cc/.
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10
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Sponholz S, Schirren M, Baldes N, Schreiner L, Fisseler-Eckhoff A, Schirren J. [Thoracic inflammatory pseudotumors : A rare differential diagnosis]. Chirurg 2018; 89:296-301. [PMID: 29305634 DOI: 10.1007/s00104-017-0581-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Inflammatory pseudotumors are a rare and in the main benign tumor entity but infiltrative growth, recurrence and metastases are described. Generally, a complete resection is needed to exclude lung cancer. This study analyzed our data and experiences with this rare tumor entity. MATERIAL AND METHODS We performed a retrospective study of all our patients who had been operated on between 2002 and 2016 in our institution for an inflammatory pseudotumor of the lungs. The extent of resection, morbidity, mortality and long-term results were analyzed. RESULTS Altogether, in this period 13 patients were operatively treated (5 women and 8 men). The median age was 52 years (range 34-74 years). A reoperation was carried out in one patient for recurrence after enucleation of the tumor in another hospital. In no case could lung cancer be excluded prior to complete resection. In total, 11 pulmonary, 1 tracheal and 1 chest wall pseudotumor could be resected by thoracotomy (9×) and thoracoscopy (3×) and 1 by ventral chest wall resection. In eight patients the resections were performed by standard resection (wedge resection or anatomic resection) and five times by extended resection. In all cases a R0 resection was achieved. Due to one case of postoperative pneumonia the morbidity and mortality rates were 7.7% and 0%, respectively. CONCLUSION The differential diagnosis between inflammatory pseudotumors and lung cancer cannot be definitely made preoperatively. For an exact diagnosis by the pathologist a complete histological preparation is needed. Due to infiltrative growth and recurrence, extended resection can be necessary for a R0 resection. This can be achieved with low morbidity and mortality. Important is an en bloc R0 resection, which is associated with good long-term results.
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Affiliation(s)
- S Sponholz
- Klinik für Thoraxchirurgie, HELIOS Dr. Horst Schmidt Klinik Wiesbaden, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland.
| | - M Schirren
- Klinik für Thoraxchirurgie, HELIOS Dr. Horst Schmidt Klinik Wiesbaden, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland
| | - N Baldes
- Klinik für Thoraxchirurgie, HELIOS Dr. Horst Schmidt Klinik Wiesbaden, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland
| | - L Schreiner
- Institut für Pathologie und Zytologie, HELIOS Dr. Horst Schmidt Klinik Wiesbaden, Wiesbaden, Deutschland
| | - A Fisseler-Eckhoff
- Institut für Pathologie und Zytologie, HELIOS Dr. Horst Schmidt Klinik Wiesbaden, Wiesbaden, Deutschland
| | - J Schirren
- Klinik für Thoraxchirurgie, HELIOS Dr. Horst Schmidt Klinik Wiesbaden, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland
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11
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Mansour-Ghanaei F, Gharibpoor A, Joukar F, Mavaddati S, Askari K, Askari SA, Gharibpoor F. Inflammatory Myofibroblastic Tumors in a Case with Hypogastric Discomfort. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:217-221. [PMID: 28250406 PMCID: PMC5344281 DOI: 10.12659/ajcr.901813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patient: Male, 68 Final Diagnosis: Inflammatory myofibroblastic tumor Symptoms: 2–3 kg weight loss • Helicobacter pylori positive which were eradicated after treatment course • hypogastric region discomfort • no association between the pain, defecation and eating • no history of HIV, diabetes, smoking and alcohol consumption was recorded • no symptoms of nausea, vomiting, fever and shaking chills • normal vital signs • tenderness in the right lower quadrant of the abdomen with no rebound state was noted Medication: — Clinical Procedure: Lab examinationt-imaging-colonoscopy-surgery Specialty: Gastroenterology and Hepatology
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Affiliation(s)
- Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Alireza Gharibpoor
- Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Farahnaz Joukar
- Caspian Digestive Diseases Research Center (CDDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Sara Mavaddati
- Caspian Digestive Diseases Research Center (CDDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Kourosh Askari
- Department of Pathology, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyed Ali Askari
- Caspian Digestive Diseases Research Center (CDDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Faeze Gharibpoor
- Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
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12
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Ju J. Inflammatory Pseudotumor of the Lung: A Rare Presentation with Complete Regression to Pharmacotherapy. Chonnam Med J 2017; 53:232-233. [PMID: 29026714 PMCID: PMC5636765 DOI: 10.4068/cmj.2017.53.3.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 08/30/2017] [Accepted: 09/04/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jinyung Ju
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea
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13
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Goto T, Akanabe K, Maeshima A, Kato R. Surgery for recurrent inflammatory pseudotumor of the lung. World J Surg Oncol 2011; 9:133. [PMID: 22004917 PMCID: PMC3215646 DOI: 10.1186/1477-7819-9-133] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 10/18/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cases of recurrent inflammatory pseudotumor have only rarely been reported. The treatment for recurrent pseudotumor is surgery. Patients not eligible for surgery require different treatment, and the optimal type of the treatment is controversial. CASE PRESENTATION A 54-year-old woman was noted to have an abnormal shadow in the right middle lung field on chest X-ray. Computed tomography of the chest revealed an infiltrative lesion in the right segment 4 and a nodule in the right segment 8. She underwent right middle lobectomy and partial resection of the right segment 8. Histopathology revealed non-atypical lymphocytes and plasma cells infiltrates, leading to the diagnosis of the lymphoplasmacytic type of inflammatory pseudotumor. During postoperative follow-up, chest computed tomography revealed a nodular lesion in the left segment 3 and an infiltrative lesion in the right segment 2. Left segment 3 segmentectomy and right segment 2 wedge resection were performed. The histopathological findings were similar to those of the first surgical specimen, leading to the diagnosis of recurrent lymphoplasmacytic type of inflammatory pseudotumor. CONCLUSION Surgical cases of recurrent inflammatory pseudotumor of the lung have been reported only very rarely. We believe that surgery is the best treatment for recurrent inflammatory pseudotumor of the lung when patients are eligible.
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Affiliation(s)
- Taichiro Goto
- Department of General Thoracic Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
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14
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Lee MH, Lee HB, Lee YC, Rhee YK, Lee EJ, Chung MJ, Jin GY, Kweon EY, Park SJ. Bilateral multiple inflammatory myofibroblastic tumors of the lung successfully treated with corticosteroids. Lung 2011; 189:433-5. [PMID: 21809057 DOI: 10.1007/s00408-011-9314-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Accepted: 07/11/2011] [Indexed: 01/25/2023]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare tumorous lesion that presents as a solitary nodule. Complete surgical resection is the standard treatment. However, due to its rarity, the optimal therapeutic strategy for multiple IMTs has not been defined. A 32-year-old man was referred to our hospital for evaluation of multiple pulmonary nodules. On computed tomography (CT) scan of the chest, there were a 3.0 × 1.7 cm mass with heterogeneous enhancement in the left upper lobe and multiple small nodules bilaterally. We performed wedge resection of the mass, and histopathology revealed IMT. He was treated with oral corticosteroids. The clinical and radiologic responses were so excellent that a CT scan showed complete resolution 1 month after the initiation of corticosteroid therapy. These observations suggest that corticosteroids may be the way to treat bilateral multiple IMT of the lung.
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Affiliation(s)
- Min Hee Lee
- Department of Internal Medicine, Research Center for Pulmonary Disorders, Chonbuk National University Medical School, Jeonju, South Korea
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15
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Racil H, Saad S, Ben Amar J, Cheikh Rouhou S, Chaouch N, Zarrouk M, Chabbou A. [Invasive inflammatory pseudotumor of the lung]. Rev Med Interne 2011; 32:e55-8. [PMID: 21396752 DOI: 10.1016/j.revmed.2010.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Revised: 12/22/2009] [Accepted: 02/06/2010] [Indexed: 10/18/2022]
Abstract
Inflammatory pseudotumor of the lung is an uncommon nonneoplastic tumor of unknown origin. It can mimic lung carcinoma. We report a 65-year-old man who presented with productive cough, weight loss, and a heterogeneous right apical lung condensation. This clinical and radiographic presentation suggested a malignant lung tumor. Surgery was performed and the histological examination of the surgical specimen concluded to an inflammatory pseudotumor. A pneumonectomy was performed because of the tumor extension towards the lower lobe and the mediastinum. No recurrence was observed after a 2-year follow-up. Surgery is essential to confirm the diagnosis of inflammatory pseudotumor. Complete resection is the only guarantee to prevent recurrence.
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Affiliation(s)
- H Racil
- Service de pneumologie endoscopie, hôpital Abderrahmane Mami, 2080 Ariana, Tunisie
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16
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Mondello B, Lentini S, Barone M, Barresi P, Monaco F, Familiari D, La Rocca A, Sibilio M, Acri IE, David A, Monaco M. Surgical management of pulmonary inflammatory pseudotumors: a single center experience. J Cardiothorac Surg 2011; 6:18. [PMID: 21345228 PMCID: PMC3049133 DOI: 10.1186/1749-8090-6-18] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 02/23/2011] [Indexed: 11/29/2022] Open
Abstract
Background The pulmonary inflammatory pseudotumor (PIP) is a rare disease. It is still debated whether it represents an inflammatory lesion characterized by uncontrolled cell growth or a true neoplasm. PIP is characterized by a cellular polymorphism. Methods We retrospectively analyzed 8 patients with PIP treated by surgery between 2001 and 2009. Preoperative thoracic computed tomography (CT) scan was performed in all cases. All patients underwent preoperative bronchoscopy with washing and brushing and/or transbronchial biopsy and preoperative cytology examination Results There were 5 men and 3 women, aged between 38 and 69 years (mean of 58 years). 3 patients (37%) were asymptomatic. The others had symptoms characterized by chest pain, shortness of breath and persistent cough or hemoptysis. 5 patients had neutrophilic leucocytosis. CT scan demonstrated solitary nodules (maximum diameter <3 cm) in 5 patients (62%) and lung masses (maximum diameter >3 cm) in 3 patients (37%). In 2 patients there were signs of pleural infiltration. Distant lesions were excluded in all cases. A preoperative histology examination failed to reach a definitive diagnosis in all patients. At surgery, we performed two lobectomies, one segmentectomy and five wedge resections, these being performed with videothoracoscopy (VATS), except for one patient where open surgery was used. Complete tumor resection was obtained in all patients. According to the Matsubara classification, there were 2 cases of organizing pneumonia, 5 cases of fibrous histiocytoma and one case of lymphoplasmacytoma. All patients were discharged alive from hospital between 4 and 7 days after surgery. At follow-up CT scan performed annually (range 11 to 112 months) (mean 58 months), there were no residual lesions, neither local nor distant recurrences. Conclusions PIP is a rare disease. Many synonyms have been used for this disease, usually in relation to the most represented cell type. The true incidence is unclear. Preoperative diagnosis is difficult to reach, despite performing a bronchoscopy or a transparietal needle aspiration. Different classifications have been proposed for PIP. Either medical, radiation or surgical therapy has been used for PIP. Whenever possible, surgery should be considered the standard treatment. Complete surgical resection is advocated to prevent recurrence.
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Affiliation(s)
- Baldassare Mondello
- Thoracic Surgery Unit, Cardiovascular and Thoracic Department, Policlinic University Hospital, University of Messina, Italy
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Behzad A, Müller A, Rösler W, Amann K, Linke R, Mackensen A. Inflammatorischer myofibroblastärer Tumor des Lymphknotens mit paraneoplastischer Thrombose und Eosinophilie. ACTA ACUST UNITED AC 2010; 105:232-6. [DOI: 10.1007/s00063-010-1030-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dagash H, Koh C, Cohen M, Sprigg A, Walker J. Inflammatory myofibroblastic tumor of the pancreas: a case report of 2 pediatric cases--steroids or surgery? J Pediatr Surg 2009; 44:1839-41. [PMID: 19735837 DOI: 10.1016/j.jpedsurg.2009.06.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 06/13/2009] [Accepted: 06/13/2009] [Indexed: 12/31/2022]
Abstract
Inflammatory pseudotumors also termed inflammatory myofibroblastic tumors (IMTs) are rare, benign, solid lesions of unclear etiology more usually found in the lung and very rarely in the pancreas. We report 2 cases and outline our management for each. The first case was treated surgically, whereas the second was treated with high-dose steroids. This represents the first reported case whereby steroid treatment has been successful in pancreatic IMT.
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Affiliation(s)
- Haitham Dagash
- Department of Pediatric Surgery, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, United Kingdom
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Kishi K, Fujii T, Kurosaki A, Nakata K, Yoshimura K. Recurrence of inflammatory pseudotumor of the lung after eleven years of remission. Intern Med 2009; 48:1079-83. [PMID: 19525603 DOI: 10.2169/internalmedicine.48.2043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The standard treatment of inflammatory pseudotumor of the lung is surgical excision. However, little data is available on steroid therapy in patients with the unresectable disease. Here, we report a patient with recurrent inflammatory pseudotumor of the lung with pleural involvement who had been successfully treated with corticosteroid eleven years previously. Like the previous treatment, retreatment with corticosteroid proved to be effective for the recurred lesion. In addition, the patient had developed extramammary Paget's disease and bladder cancer after the initial onset of inflammatory pseudotumor. Steroid therapy could be an optional modality in treating unresectable inflammatory pseudotumor, although long-term follow-up is definitely necessary.
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Affiliation(s)
- Kazuma Kishi
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo.
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Fabre D, Fadel E, Singhal S, de Montpreville V, Mussot S, Mercier O, Chataigner O, Dartevelle PG. Complete resection of pulmonary inflammatory pseudotumors has excellent long-term prognosis. J Thorac Cardiovasc Surg 2008; 137:435-40. [PMID: 19185166 DOI: 10.1016/j.jtcvs.2008.07.009] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Revised: 04/13/2008] [Accepted: 07/04/2008] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Pulmonary inflammatory pseudotumor is an uncommon disease, often with a benign presentation. However, invasion of adjacent thoracic organs, local recurrence, and distant metastases have been described, and the best management strategy remains unclear. We present a single large institutional experience in patients with pulmonary inflammatory pseudotumor and propose guidelines for treatment of this patient population. METHODS A retrospective study was performed to review all patients who underwent resection for pulmonary inflammatory pseudotumor between 1974 and 2007. RESULTS A total of 25 patients were treated with pulmonary inflammatory pseudotumor at the Marie Lannelongue Hospital. The mean age was 33 years. Two patients were referred after an incomplete resection. One patient presented with cerebral metastasis. We performed a complete resection in all patients: wedge resection (n = 7), lobectomy (n = 6), sleeve arterial lobectomy (n = 1), lobectomy with thoracic inlet exenteration (n = 2), bilobectomy (n = 2), pneumonectomy with brain metastasectomy (n = 1), sleeve pneumonectomy (n = 2), sleeve main bronchus or tracheal resection (n = 2), wedge with sleeve main pulmonary artery resections (n = 1), and sleeve pneumonectomy with esophageal, aortic arch, and right pulmonary artery resection (n = 1). No adjuvant therapy was given to any patients. Postoperative 30-day mortality and morbidity rates were 4% and 8%, respectively. With a mean follow-up of 80 months (range 4-369 months, 100% follow-up), actuarial 10-year survival was 89%. One patient died of an extensive sarcomatous recurrence 2 years after surgery. CONCLUSION Pulmonary inflammatory pseudotumor is a malignant disease affecting young patients with local invasion, distant metastasis, local recurrence, and sarcomatous degeneration. A complete resection should always be performed at initial presentation because of its high likelihood of cure with aggressive management.
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Affiliation(s)
- Dominique Fabre
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie-Lannelongue, Le Plessis Robinson, Paris-Sud University, France
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Yokoyama H, Kume H, Niimi A, Tomota K, Kitamura T. Plasma cell granuloma of urethra in a young woman. Am J Obstet Gynecol 2007; 196:e9-e10. [PMID: 17346518 DOI: 10.1016/j.ajog.2006.10.907] [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: 07/03/2006] [Revised: 10/13/2006] [Accepted: 10/27/2006] [Indexed: 11/25/2022]
Abstract
This report describes an unfamiliar vulval mass that looked unidentifiable initially, but then was determined histologically to be urethral plasma cell granuloma. The lung is most commonly involved in plasma cell granuloma, and extrapulmonary lesions are considered uncommon. In particular, urethral plasma cell granuloma seems to be extremely rare.
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Kobashi Y, Fukuda M, Nakata M, Irei T, Oka M. Inflammatory pseudotumor of the lung: clinicopathological analysis in seven adult patients. Int J Clin Oncol 2006; 11:461-6. [PMID: 17180515 DOI: 10.1007/s10147-006-0611-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2006] [Accepted: 08/08/2006] [Indexed: 01/03/2023]
Abstract
BACKGROUND As the origin and pathology of inflammatory pseudotumor is not clearly understood, there has recently been some confusion regarding the diagnosis of inflammatory pseudotumor. METHODS We performed clinicopathological analyses in seven patients with inflammatory pseudotumors of the lung histologically diagnosed after surgical resection. The seven patients, selected from patients admitted to Kawasaki Medical School Hospital between April 1989 and December 2005, consisted of four men and three women (average age, 60.4 years). The detection method was from clinical symptoms in two patients and from health examinations in five patients. RESULTS Five patients had a solitary nodular shadow on chest radiographs and the other two patients had multiple shadows. Because it was difficult to distinguish pseudotumor from lung cancer by chest computed tomography in the five patients showing a solitary nodular shadow, the final diagnosis was obtained by surgical resection. In the other two patients, with multiple shadows, one of whom had nodular shadows with cavitary lesions, surgical resection was performed to distinguish the pseudotumor from metastatic lung cancer. The histological types according to the criteria of Matsubara were fibrous histiocytic in five patients, organizing pneumonia in one, and lymphoplasmocytic in one. The histological types according to the World Health Organization criteria were compact spindle-cell pattern in six patients and hypocellular fibrous pattern in one. CONCLUSION Because it is difficult to make a preoperative diagnosis of inflammatory pseudotumor by radiological findings or histological findings using specimens obtained by transbronchial lung biopsy, surgical resection, such as video-assisted thoracic surgery or open lung biopsy, is required to differentiate inflammatory pseudotumors from primary or metastatic lung cancers.
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Affiliation(s)
- Yoshihiro Kobashi
- Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
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Abdennadher M, Kolsi M, Khabir A, Abdelmalek M, Boudaoura T, Frikha I. Tumeur myofibroblastique pulmonaire : intérêt de la chirurgie première. Rev Mal Respir 2005; 22:1043-7. [PMID: 16598865 DOI: 10.1016/s0761-8425(05)85736-5] [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: 10/22/2022]
Abstract
INTRODUCTION Myofibroblastic tumours or pulmonary pseudotumours are rare and, though benign, they may become invasive and recur after excision. CASE REPORT We report the case of a child aged 14, presenting with mild haemoptysis, who had a solitary nodule at the base of the left lung. CT scanning suggested a hypervascular tumour. Fibreoptic bronchoscopy was normal and it was not possible to perform percutaneous biopsy on account of its proximal situation. A lobectomy was performed via a postero-lateral thoracotomy with a successful outcome. Histological examination revealed a myofibroblastic tumour. CONCLUSION Recourse to primary surgery is essential to confirm the diagnosis of a myofibroblastic pulmonary tumour. Complete resection is the only guarantee to prevent recurrence.
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Affiliation(s)
- M Abdennadher
- Service de Chirurgie Thoracique et Cardiovasculaire, CHU Habib Bourguiba, Sfax, Tunisie.
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Ferbend P, Abramson LP, Backer CL, Mavroudis C, Webb CL, Doll JA, Junewick JJ, Crawford SE. Cardiac plasma cell granulomas: response to oral steroid treatment. Pediatr Cardiol 2004; 25:406-10. [PMID: 15054564 DOI: 10.1007/s00246-003-0269-x] [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] [Indexed: 10/26/2022]
Abstract
Plasma cell granulomas are lesions of uncertain histogenesis arising in a variety of locations, most commonly the lung. Treatment for these lesions is complete surgical excision if possible. Unresectable pulmonary lesions respond to oral corticosteroids and radiation therapy. We report the long-term outcome of two unusual pediatric cases of cardiac plasma cell granulomas originating within the right ventricle and posterior aspect of the left ventricle. The limited literature reports advocate surgical resection for this entity, with no discussion of alternative treatment strategies for unresectable lesions. We prospectively evaluated the response to postoperative oral steroid therapy, as complete surgical excision was not possible in either case. Sequential echocardiography demonstrated additional significant reduction in the size of the masses and the patients remain asymptomatic at 9 and 5.5 years follow-up, without evidence of obstruction or recurrence. Oral corticosteroids should be considered as a treatment option for any unresectable plasma cell granuloma.
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Affiliation(s)
- P Ferbend
- Dept of Pathology, Roger Williams Medical Center, Providence, RI 02908, USA
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Laurent S, Mouthon L, Longchampt E, Roudaire M, Franc S, Krivitzky A, Cohen R. Medical cure of plasma cell granuloma of the thyroid associated with Hashimoto's thyroiditis: a case report and review. J Clin Endocrinol Metab 2004; 89:1534-7. [PMID: 15070909 DOI: 10.1210/jc.2003-031355] [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] [Indexed: 02/12/2023]
Abstract
Plasma cell granuloma (PCG) is a rare, benign inflammatory tumor composed of myofibroblasts, abundant plasma cells, and lymphocytes combined with collagen. A thyroid localization of PCG is extremely rare, and surgical therapy is indicated. We report the case of a 35-yr-old woman with a thyroid PCG, associated with Hashimoto's thyroiditis, that was responsible for tracheal compression. Surgery was performed, but the thyroid could not be removed because of the fibrotic process. The patient was treated with corticosteroids and immunosuppressive therapy. Dyspnea and dysphagia improved within 1 month, whereas thyroid volume returned to normal within 3 yr. We also review other reports of thyroid PCG in the literature and discuss the differential diagnosis and treatment. Although the use of immunosuppressive therapy has never been reported for thyroid PCG until now, this treatment may represent a good alternative to surgery in life-threatening, unresectable PCG.
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Affiliation(s)
- Silvana Laurent
- Internal Medicine and Endocrinology Unit, University Paris XIII and Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, 93009 Bobigny, France
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Affiliation(s)
- Juliette L Wohlrab
- Division of Pulmonary, Critical Care, and Sleep Medicine, Georgetown University Medical Center, Washington, DC 20007, USA.
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Abstract
Inflammatory pseudotumors of the esophagus are uncommon. They pose diagnostic and therapeutic dilemmas, especially when located in the cervical esophagus. History and physical examination are rarely contributory. Routine radiologic investigations including barium swallow and computed tomography only raise the suspicion of a benign esophageal neoplasm. Esophagoscopy and biopsy do not provide a definite diagnosis, as these 'tumors' are frequently submucosal, unless they enlarge sufficiently to cause mucosal ulcerations. Endoscopic ultrasonography may accurately localize the tumor but is not diagnostic. Conservative surgical resection or debulking would be both diagnostic and therapeutic. Steroids, cyclophosphamide and low-dose radiotherapy may at best be considered second-line therapy. One such case of inflammatory pseudotumor of the cervical esophagus is presented and the relevant literature is reviewed. Our patient could not be diagnosed on preoperative investigations and required an esophagotomy with frozen section. We debulked the mass and the patient is asymptomatic 6 months after surgery.
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Affiliation(s)
- A P Saklani
- Department of Thoracic Surgical Services, Tata Memorial Hospital, Mumbai, India
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Kilinç M, Ertürk IO, Uysal H, Birler K, Evrenkaya T, Akkalyoncu BB. Multiple plasma cell granuloma of the central nervous system: a unique case with brain and spinal cord involvement. Case report and review of literature. Spinal Cord 2002; 40:203-6. [PMID: 11965561 DOI: 10.1038/sj.sc.3101271] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
STUDY DESIGN Single subject (male, 34 years-of-age) case report. OBJECTIVES To describe a unique case of plasma cell granuloma (PCG) with simultaneous brain and spinal cord involvement. SETTING Private hospital, capital city, Turkey. METHODS The patient presented with headache and paraplega. T2 weighted MR images showed multiple hyperintense cerebral, cerebellar, brainstem and spinal cord lesions that enhanced homogeneously with contrast medium. The patient was operated on, and the two intramedullary spinal cord lesions at T11 and T12 were totally excised. RESULTS After 3 months of an intense physiotherapy programme the patient was able to walk with help. CONCLUSION We report for the first time, the occurrence of multiple, simultaneous brain and intramedullary spinal cord plasma cell granulomas.
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Affiliation(s)
- M Kilinç
- Baskent University Hospital, Neurology Department, Bahçelievler-Ankara, Turkey 06490
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Nakajima T, Sano S, Itami S, Yoshikawa K. Cutaneous inflammatory pseudotumour (plasma cell granuloma). Br J Dermatol 2001; 144:1271-3. [PMID: 11422062 DOI: 10.1046/j.1365-2133.2001.04253.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Gorospe L, Fernández-Gil MA, Torres I, Tovar J, García-Miguel P, Tejerina E. Misleading lead: inflammatory pseudotumor of the mediastinum with digital clubbing. MEDICAL AND PEDIATRIC ONCOLOGY 2000; 35:484-7. [PMID: 11070481 DOI: 10.1002/1096-911x(20001101)35:5<484::aid-mpo7>3.0.co;2-t] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- L Gorospe
- Department of Radiology, "La Paz" University Hospital, Madrid, Spain.
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Messineo A, Mognato G, D'Amore ES, Antoniello L, Guglielmi M, Cecchetto G. Inflammatory pseudotumors of the lung in children: conservative or aggressive approach? MEDICAL AND PEDIATRIC ONCOLOGY 1998; 31:100-4. [PMID: 9680935 DOI: 10.1002/(sici)1096-911x(199808)31:2<100::aid-mpo10>3.0.co;2-r] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Inflammatory pseudotumors (inflammatory myofibroblastic tumors) of the lung are myofibroblastic lesions of controversial nosology. The concept that these are benign lesions has been recently questioned given their capacity for local invasion and recurrence. PROCEDURE AND RESULTS We observed five children with inflammatory pseudotumors of the lung in whom the tumor was resected using the most limited excision possible. Unusually, in all five cases the tumor was localized in the right upper lobe: Three were parenchymal, and the others involved the bronchus. The three parenchymal masses underwent wedge resection, whereas the two bronchial lesions required ex-cision followed by a bronchoplasty and an up-per lobectomy, respectively. In all, the pathology showed a complete resection, and the patients had uneventful recoveries. Follow-ups, including CT and bronchoscopies, ranged from 4 to 8 years (mean of 6.4 years) with no signs of recurrence. CONCLUSIONS Our limited experience supports the idea that excisional surgery is the treatment of choice for inflammatory pseudotumors of the lung. Such excisions, both diagnostic and curative, carry minimal risks and avoid unnecessary mutilation. Closely monitored follow-up is mandatory, as the natural history of this lesion is not yet well understood.
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Affiliation(s)
- A Messineo
- Department of Pediatrics, University of Padua, Italy
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Díez Piña J, Fernández Vázquez E, Sáez Roca G, Cañizares Sevilla F, Marín Aznar J, López de la Osa A. Seudotumor inflamatorio multifocal del pulmón con buena respuesta a corticoides. Arch Bronconeumol 1998. [DOI: 10.1016/s0300-2896(15)30490-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Piroth L, Menecier P, Charvillat L, Naouri A, Kisterman JP. [Diagnostic and therapeutic approach to plasma cell granuloma of the lung. Apropos of a case of favourable course under antibiotics]. Rev Med Interne 1996; 17:670-4. [PMID: 8881195 DOI: 10.1016/0248-8663(96)87153-0] [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: 02/02/2023]
Abstract
Plasma cell granulomas are more often solitary benign tumoral lesions, which need early surgery both for diagnostic and therapeutic reasons. The authors report a case of multiple plasma cell granuloma, diagnosed on biopsies obtained by thoracoscopy, and with a good response to a long-term antibiotic treatment. A review of the literature shows that this behaviour may represent an interesting alternative to systematical surgery in some cases.
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Affiliation(s)
- L Piroth
- Service de médecine interne et maladies infectieuses, centre hospitalier Les Chanaux, Mâcon, France
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