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Hamasaki R, Kitazawa K. Multiple hepatic nodular lesions in an infant with febrile urinary tract infection. BMJ Case Rep 2024; 17:e260245. [PMID: 38866582 DOI: 10.1136/bcr-2024-260245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Affiliation(s)
- Ryo Hamasaki
- Department of Pediatrics, Asahi General Hospital, Asahi, Japan
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2
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Yamashita T, Matsubayashi Y, Mochizuki T. Traumatic tumor hemorrhage of inflammatory myofibroblastic tumor of the lung. Respir Med Case Rep 2024; 47:101981. [PMID: 38288137 PMCID: PMC10823134 DOI: 10.1016/j.rmcr.2024.101981] [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: 08/30/2023] [Revised: 12/31/2023] [Accepted: 01/08/2024] [Indexed: 01/31/2024] Open
Abstract
A 23-year-old female with a history of idiopathic epilepsy was found to have a right chest cavity shadow in a school health checkup 5 years before. CT revealed a thin-walled cavity lesion in the right middle lobe containing a ball-like mass, showing air crescent sign. After falling due to a seizure, she was transported by ambulance and admitted. CT revealed diffuse ground-glass opacities throughout the right lung field. Bronchoscopy revealed bloody bronchial alveolar lavage fluid. Due to the tumor hemorrhage, an elective simple right middle lobe resection was performed without complications. The initial immunohistochemical staining was negative for ALK using ALK1 clone; however, subsequent staining of ALK by D5F3 and 5A4 clone was positive. Immunostaining findings led to a diagnosis of inflammatory myofibroblastic tumor. The patient remains under regular observation and has experienced no recurrence over the 6-year postoperative period. This case contains two different points: the first is that a cavity lesion of inflammatory myofibroblastic tumor may cause traumatic bleeding and should be treated with caution; the second is that attention should be paid to differences in stainability among clones when diagnosing inflammatory myofibroblastic tumor.
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Affiliation(s)
- Takashi Yamashita
- Department of Thoracic Surgery, Iwata City Hospital, 512-3, Ohkubo, Iwata, Shizuoka, 438-8550, Japan
| | - Yuta Matsubayashi
- Department of Thoracic Surgery, Iwata City Hospital, 512-3, Ohkubo, Iwata, Shizuoka, 438-8550, Japan
| | - Takahiro Mochizuki
- Department of Thoracic Surgery, Iwata City Hospital, 512-3, Ohkubo, Iwata, Shizuoka, 438-8550, Japan
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3
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Bellur S, Balasundaram S. Giant lung tumor in hereditary spherocytosis: inflammatory myofibroblastic tumor. Indian J Thorac Cardiovasc Surg 2023; 39:274-277. [PMID: 37124597 PMCID: PMC10140209 DOI: 10.1007/s12055-022-01464-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023] Open
Abstract
Inflammatory myofibroblastic tumors are a rare subset of lung lesions in the adult age group. They pose a diagnostic challenge as they present with non-specific findings. We report a 27-year-old female with an inflammatory myofibroblastic tumor on a background of hereditary spherocytosis.
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Affiliation(s)
- Shreyas Bellur
- Department of Cardiothoracic and Vascular Surgery, St. John’s Medical College Hospital, Bangalore, 560034 Karnataka India
| | - Sreekar Balasundaram
- Department of Cardiothoracic and Vascular Surgery, St. John’s Medical College Hospital, Bangalore, 560034 Karnataka India
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4
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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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5
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Alves CHL, Alves GS, Ferreira AAMF, Lacerda EMDCB, Tomaz C. Cognitive evaluation following the evolution of brain myofibroblastic tumor in the adolescence: a case study report. JORNAL BRASILEIRO DE PSIQUIATRIA 2022. [DOI: 10.1590/0047-2085000000382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ABSTRACT Objective To report the case of a teenager (12 years old) diagnosed with a brain tumor in the right frontal-parietal region emphasizing the main characteristics observed in neuropsychological examinations. Methods In the pre-surgical evaluation, the patient presented behavioral alterations, including deficits in verbal comprehension, perceptual organization, working memory, processing speed, and slight alterations regarding constructive praxis. Results A reevaluation after two years surgery revealed significant improvement in verbal and perceptual comprehension and constructive praxis while remaining a slight change in processing speed. These results suggest that the tumor’s surgical resection produced significant improvements in the patient’s neurocognitive context, especially in executive functions. This study also indicates that Neuropsychological evaluation are useful for pre- and post- surgical evaluation of cognitive functioning and its evolution. Conclusion Brain tumor causes cognitive and behavioral changes and its resection can result in improvements in the patient’s quality of life.
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Porrino J, Al-Dasuqi K, Irshaid L, Wang A, Kani K, Haims A, Maloney E. Update of pediatric soft tissue tumors with review of conventional MRI appearance-part 1: tumor-like lesions, adipocytic tumors, fibroblastic and myofibroblastic tumors, and perivascular tumors. Skeletal Radiol 2022; 51:477-504. [PMID: 34191084 DOI: 10.1007/s00256-021-03836-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/22/2021] [Accepted: 06/02/2021] [Indexed: 02/02/2023]
Abstract
There are numerous soft tissue tumors and tumor-like conditions in the pediatric population. Magnetic resonance imaging is the most useful modality for imaging these lesions. Although certain soft tissue lesions exhibit magnetic resonance features characteristic of a specific diagnosis, most lesions are indeterminate, and a biopsy is necessary for diagnosis. We provide a detailed update of soft tissue tumors and tumor-like conditions that occur in the pediatric population, emphasizing each lesion's conventional magnetic resonance imaging appearance, using the recently released 5th edition of the World Health Organization Classification of Soft Tissue and Bone Tumors as a guide. In part one of this review, pediatric tumor-like lesions, adipocytic tumors, fibroblastic and myofibroblastic tumors, and perivascular tumors are discussed. In part two, vascular lesions, fibrohistiocytic tumors, muscle tumors, peripheral nerve sheath tumors, tumors of uncertain differentiation, and undifferentiated small round cell sarcomas are reviewed. Per the convention of the WHO, these lesions involve the connective, subcutaneous, and other non-parenchymatous-organ soft tissues, as well as the peripheral and autonomic nervous system.
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Affiliation(s)
- Jack Porrino
- Yale Radiology and Biomedical Imaging, 330 Cedar Street, New Haven, CT, 06520, USA.
| | - Khalid Al-Dasuqi
- Yale Radiology and Biomedical Imaging, 330 Cedar Street, New Haven, CT, 06520, USA
| | - Lina Irshaid
- Yale School of Medicine Department of Pathology, 333 Cedar Street, New Haven, CT, 06520, USA
| | - Annie Wang
- Yale Radiology and Biomedical Imaging, 330 Cedar Street, New Haven, CT, 06520, USA
| | - Kimia Kani
- Department of Radiology, University of Maryland Medical Center, 22 S Greene St, Baltimore, MD, 21201, USA
| | - Andrew Haims
- Yale Radiology and Biomedical Imaging, 330 Cedar Street, New Haven, CT, 06520, USA
| | - Ezekiel Maloney
- Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA
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7
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Zhu T, Gao P, Gao J, Liu X, Zhang X. A huge recurrent retroperitoneal inflammatory myofibroblastic tumor implicating renal and ureter: a case report. Transl Cancer Res 2022; 10:4565-4570. [PMID: 35116312 PMCID: PMC8798890 DOI: 10.21037/tcr-21-899] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/30/2021] [Indexed: 12/05/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare sarcoma with unique molecular characteristics. It also has typical fasciitis-like, dense spindle cells and hypocellular fibrous histologic patterns and can occur at any age. The etiology of IMT is unknown and a complete treatment and monitoring plan for IMT have not been developed. We have found a rare case about a huge recurrent IMT implicating renal and ureter. The patient was accompanied by a history of a lesion sized 15.5 cm × 11.5 cm × 10.5 cm as a retroperitoneal IMT, and the first tumor resection was performed 12 months ago. The patient, who suffered from tumor recurrence within 1 year and whose recurrent tumor also invaded into the renal parenchymal was given a retroperitoneal neoplasm resection plus right nephrectomy. In order to clarify the pathological features, the histological specimens of recurrent retroperitoneal IMT were examined as well as primary retroperitoneal IMT, and immunohistochemical (IHC) stains showed that the spindle cells were positive for vimentin and negative for anaplastic lymphoma kinase (ALK). At 24 months follow-up, the patient recovered well and there was no evidence of tumor recurrence. This case report is conducive to understanding this rare tumor. When conditions permit, complete surgical resection is the recommended treatment for primary and recurrent IMT.
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Affiliation(s)
- Tianle Zhu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Pan Gao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jingjing Gao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xi Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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8
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Lin YT, Huang SH, Chang CH, Hsu PC, Wang CW, Lee CS. First report of an adult female patient with endobronchial inflammatory myofibroblastic tumor in Taiwan: A case report. Thorac Cancer 2021; 12:2807-2810. [PMID: 34520108 PMCID: PMC8520803 DOI: 10.1111/1759-7714.14104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/26/2022] Open
Abstract
An inflammatory myofibroblastic tumor (IMT) of the respiratory system is an uncommon disease. In Taiwan, there is a lack of previous studies on tracheobronchial IMT. The tumor is characterized by overexpression of anaplastic lymphoma receptor tyrosine kinase (ALK)‐1. Surgical resection is the standard treatment of choice nowadays.
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Affiliation(s)
- Yan-Ting Lin
- Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taipei, Taiwan
| | - Shih-Hao Huang
- Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taipei, Taiwan.,Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taipei, Taiwan.,Department of Pulmonary and Critical Care Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan
| | - Chih-Hao Chang
- Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taipei, Taiwan.,Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taipei, Taiwan.,Department of Pulmonary and Critical Care Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan
| | - Ping-Chi Hsu
- Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taipei, Taiwan.,Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taipei, Taiwan
| | - Chih-Wei Wang
- Department of Anatomic Pathology, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Chung-Shu Lee
- Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taipei, Taiwan.,Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taipei, Taiwan.,Department of Pulmonary and Critical Care Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan
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9
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Perkins SJ, Gao R, Glazer TA, Zhao CX, Basura G, McKean EL. Treatment and Prognosis of Inflammatory Pseudotumor of the Skull Base. J Neurol Surg B Skull Base 2021; 83:e555-e563. [DOI: 10.1055/s-0041-1735558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/25/2021] [Indexed: 10/20/2022] Open
Abstract
Abstract
Background Inflammatory pseudotumor (IPT) of the skull base is a rare, locally destructive lesion managed with a variety of treatments. We explore the impact of treatment on outcome and assess the prognosis of IPT.
Methods This is a retrospective review of IPT of the skull base at a tertiary academic medical center. The primary outcome was radiographic progression after treatment. Outcome versus tumor location was also examined and a prognostic model was developed using a logistic regression.
Results The demographics of 21 patients with IPT are reported. Treatment consisted of corticosteroids (in 80.1% of patients), disease modifying antirheumatic drugs (DMARDs; 33.3%), surgical resection (28.6%), radiation (23.8%), antibiotics (14.3%), chemotherapy (rituximab; 9.5%), and antivirals (4.8%). At 50.7 months, 50.8% had radiographic progression. Local therapy trended toward having a better response than systemic therapy (p = 0.60). IPT of the orbit required 2.4 treatment modalities, compared with 2.0 for pharyngeal IPT, and 1.3 for posterior skull base masses (p = 0.14). A total of 75% orbital IPT underwent radiographic progression, compared with 71% of pharyngeal IPT and 50% of posterior skull base masses (p = 0.62). Sixteen patients were used to create the logistic model of radiographic progression. The Cox–Snell R
2 was 0.71 (p = 0.03). No individual variables were statistically significant.
Conclusion To our knowledge, this is among the largest sample of cases describing the presentation, treatment, and prognosis of IPT of the skull base. Our data suggest that there may be an improved response with local therapy over systemic therapy and better prognosis among posterolateral skull base masses.
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Affiliation(s)
- Sidney J. Perkins
- Medical School, University of Michigan Medical School, Ann Arbor, Michigan, United States
| | - Rebecca Gao
- Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Tiffany A. Glazer
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin, Madison, Wisconsin, United States
| | - Cher X. Zhao
- Department of Otolaryngology, Harvard Medical School, Pediatric Otolaryngology, Massachusetts Eye and Ear, Boston, MA 02114, United States
| | - Gregory Basura
- Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Erin L. McKean
- Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
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Strainiene S, Sedleckaite K, Jarasunas J, Savlan I, Stanaitis J, Stundiene I, Strainys T, Liakina V, Valantinas J. Complicated course of biliary inflammatory myofibroblastic tumor mimicking hilar cholangiocarcinoma: A case report and literature review. World J Clin Cases 2021; 9:6155-6169. [PMID: 34368338 PMCID: PMC8316968 DOI: 10.12998/wjcc.v9.i21.6155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/30/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The inflammatory myofibroblastic tumor (IMT) is a rare, idiopathic, usually benign, mass-forming disease with myofibroblastic proliferation and a varying amount of inflammatory cells. Although it can affect various organs, the biliary tract is a rare localization of primary IMT, clinically, endoscopically and radiologically imitating cholangiocarcinoma. The treatment options are based only on clinical practice experience.
CASE SUMMARY A 70-year-old woman was referred to our center due to progressive fatigue, weight loss, abdominal pain, night sweats, and elevated liver enzymes. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP) revealed proximal common hepatic duct and hilar biliary strictures extending bilaterally to lobular bile ducts. Although initial clinical, endoscopic and radiological signs were typical for hilar cholangiocarcinoma, histological examination showed no signs of malignancy. In total, 8 biopsies using different approaches were performed (several biopsies from dominant stricture during ERCP and direct cholangioscopy; ultrasound-guided liver biopsy; diagnostic laparoscopy with liver and lymph node biopsies). Histological examination revealed signs of IMT, and the final diagnosis of biliary IMT was stated. Although IMT is usually a benign disease, in our case, it was complicated. All pharmacological treatment measures were ineffective. The patient still needs permanent stenting, suffers from recurrent infections and mechanical jaundice. Despite that, the patient already survived 24 mo.
CONCLUSION IMT presenting with hilar biliary strictures is a unique diagnostic and clinical challenge as it is indistinguishable from cholangiocarcinoma, and there are no evidence-based treatment options. Our goal is to increase the understanding of this rare disease and its possible course.
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Affiliation(s)
- Sandra Strainiene
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | | | - Juozas Jarasunas
- Department of Radiology, Nuclear Medicine and Medical Physics, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Ilona Savlan
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Juozas Stanaitis
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Ieva Stundiene
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Tomas Strainys
- Clinic of Anesthesiology and Intensive Care Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Valentina Liakina
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
- Department of Chemistry and Bioengineering, Faculty of Fundamental Science, Vilnius Gediminas Technical University, Vilnius 10223, Lithuania
| | - Jonas Valantinas
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
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11
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Yang F, Zhang W, Han C, Jiang H. A case of pulmonary inflammatory myofibroblastic tumor treated with bronchoscopic therapy plus lobectomy. J Cardiothorac Surg 2021; 16:144. [PMID: 34039398 PMCID: PMC8157757 DOI: 10.1186/s13019-021-01528-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/07/2021] [Indexed: 11/28/2022] Open
Abstract
Background Inflammatory myofibroblastic tumor (IMT) is a rare tumor with malignant potential. We presented a case of a young adult who was diagnosed with IMT and treated with loop electrocautery therapy to relieve airway obstruction, followed by lobectomy to complete resection. Recent studies have supported the use of such interventional resection methods. Case presentation A non-smoking 30-year-old woman presented with a 1-month history of progressive dyspnea and productive cough. The Chest X-ray showed a homogenous opacity invading the entire left hemithorax, and the mediastinum content was attracted to the left side. In an effort to avoid pneumonectomy and afford rapid palliation of dyspnea, loop electrocautery was selected as the most appropriate therapy. The left upper lobectomy by thoracoscopy was performed instead of left upper lobe sleeve resection in order to better prevent the recurrence of lung atelectasis. After 6 years of follow-up, no evidence of recurrence has been found till now. Conclusion Interventional bronchoscopy coupled with surgical resection serves not only as a palliative management to bronchial obstruction but also a way to avoid pneumonectomy.
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Affiliation(s)
- Fan Yang
- Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 Qingchun East Road, Jianggan District, Hangzhou, 310016, China
| | - Wenxia Zhang
- Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 Qingchun East Road, Jianggan District, Hangzhou, 310016, China
| | - Cheng Han
- Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 Qingchun East Road, Jianggan District, Hangzhou, 310016, China
| | - Hanliang Jiang
- Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 Qingchun East Road, Jianggan District, Hangzhou, 310016, China.
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12
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Chatterjee A, Sen Dutt T, Ghosh P, Mukhopadhyay S, Chandra A, Sen S. Inflammatory Lesions Mimicking Chest Malignancy: CT, Bronchoscopy, EBUS, and PET Evaluation From an Oncology Referral Center. Curr Probl Diagn Radiol 2021; 51:235-249. [PMID: 33483189 DOI: 10.1067/j.cpradiol.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/19/2020] [Accepted: 12/31/2020] [Indexed: 11/22/2022]
Abstract
Infective and inflammatory diseases can mimic malignancy of the lung. Granulomatous inflammations are common causes of pulmonary nodule, mass, or nodal disease. Systemic infection or inflammation also commonly involves the lung that may raise suspicion of a malignant process. Even in patients with a known malignancy, inflammatory diseases can simulate new metastasis or disease progression. Knowledge of the imaging features of these diseases is essential to prevent missed or overdiagnosis of malignancy. Radiologists also need to be familiar with the scope and limitations of bronchoscopy, endobronchial ultrasound, PET-CT, and biopsy to guide clinical management. In this review, we discuss the imaging features and diagnostic approach of common mimickers of chest malignancy that involve the chest wall, pleura, lung parenchyma, and mediastinal nodes.
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Affiliation(s)
- Argha Chatterjee
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India.
| | - Tiyas Sen Dutt
- Department of Pulmonology, Tata Medical Center, Kolkata, West Bengal, India
| | - Priya Ghosh
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Sumit Mukhopadhyay
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Aditi Chandra
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Saugata Sen
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
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13
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Collinson AC, Hui AC, Coppin B, Manudhane R. 'Always biopsy the abscess and culture the tumour': An unusual cause of fever in a paediatric patient. J Paediatr Child Health 2020; 56:1963-1965. [PMID: 32162762 DOI: 10.1111/jpc.14809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/19/2019] [Accepted: 01/23/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Anne C Collinson
- Department of Paediatrics, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Adrian Cy Hui
- Department of Pathology, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Brian Coppin
- Department of Paediatrics, Flinders Medical Centre, Adelaide, South Australia, Australia.,Department of Paediatrics, Flinders University, Adelaide, South Australia, Australia
| | - Rebecca Manudhane
- Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, Adelaide, South Australia, Australia
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14
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Gopalan S, Raghu V. Unravelling the Mysteries of the Mesentery. JOURNAL OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY 2020. [DOI: 10.1055/s-0040-1718247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
AbstractThe mesentery and its folds tether the small bowel loops to the posterior abdominal wall. It transmits nerves, vessels, and lymph ensconced in a fatty sponge layer wrapped in a thin glistening peritoneum, from and to the small bowel. Not only does this flexible dynamic fatty apron house various localized primary benign and malignant lesions, it is often involved in and gives an indication of generalized or systemic diseases in the body. An understanding of the anatomy, components, and function of the mesentery helps to classify mesenteric abnormalities. This further allows for characterizing radiological patterns and appearances specific to certain disease entities. Recent reviews of mesenteric anatomy have kindled new interest in its function and clinical applications, heralding the possibility of revision of its role in diseases of the abdomen.
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Affiliation(s)
- Sunita Gopalan
- Department of Radiology, Columbia Asia Radiology Group, Columbia Asia Referral Hospital, Bengaluru, Karnataka, India
| | - Vineetha Raghu
- Department of Radiology, Columbia Asia Radiology Group, Columbia Asia Referral Hospital, Bengaluru, Karnataka, India
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15
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Menon J, Shanmugham N, Vij M, Srinivas S, Reddy S, Rela M. Peribiliary Pseudotumor Like Presentation of IgG4 Related Disease. Indian J Pediatr 2020; 87:875-876. [PMID: 32419100 DOI: 10.1007/s12098-020-03328-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/28/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Jagadeesh Menon
- Department of Pediatric Gastroenterology & Hepatology, Dr Rela Institute & Medical Center, Bharat Institute of Higher Education and Research, Chennai, India
| | - Naresh Shanmugham
- Department of Pediatric Gastroenterology & Hepatology, Dr Rela Institute & Medical Center, Bharat Institute of Higher Education and Research, Chennai, India.
| | - Mukul Vij
- Department of Histopathology, Dr Rela Institute & Medical Center, Bharat Institute of Higher Education and Research, Chennai, India
| | - Sripriya Srinivas
- Department of Radiology & Imaging Services, Dr Rela Institute & Medical Center, Bharat Institute of Higher Education and Research, Chennai, India
| | - Srinivas Reddy
- Department of Hepatobiliary Surgery & Liver Transplantation, Dr Rela Institute and Medical Center, Bharat Institute of Higher Education and Research, Chennai, India
| | - Mohamed Rela
- Department of Hepatobiliary Surgery & Liver Transplantation, Dr Rela Institute and Medical Center, Bharat Institute of Higher Education and Research, Chennai, India.,Liver Transplant Unit, Kings College Hospital, London, UK
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16
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Ramirez IA, Rubalcava NS, Mychaliska GB, Rabah R, Arteta M. Recurrent endobronchial inflammatory myofibroblastic tumors: Novel treatment options. Pediatr Pulmonol 2020; 55:788-790. [PMID: 31986238 DOI: 10.1002/ppul.24666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 01/04/2020] [Indexed: 11/12/2022]
Abstract
Endobronchial inflammatory myofibroblastic tumors (IMTs) rarely occur in children younger than 10 years of age and have intermediate malignant potential. A 7-year-old girl initially presented with pneumonia. After failing outpatient treatment, she re-presented in status asthmaticus. Computed tomography showed a left mainstem endobronchial mass which was resected bronchoscopically. Pathology was consistent with IMT. Surveillance bronchoscopy identified a recurrence. Despite a left upper lobectomy, recurrence led to further treatment with celecoxib and argon plasma coagulation. Follow-up bronchoscopy revealed complete resolution. She remains disease and symptom-free at her six-year follow-up.
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Affiliation(s)
- Ixsy A Ramirez
- Division of Pediatric Pulmonology, Department of Pediatrics, CS Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor, Michigan
| | - Nathan S Rubalcava
- Section of Pediatric Surgery, Department of Surgery, CS Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor, Michigan
| | - George B Mychaliska
- Section of Pediatric Surgery, Department of Surgery, CS Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor, Michigan
| | - Raja Rabah
- Division of Pediatric Pathology, Department of Pathology, Michigan Medicine, CS Mott and Von Voigtlander Women's Hospitals, Ann Arbor, Michigan
| | - Manuel Arteta
- Division of Pediatric Pulmonology, Department of Pediatrics, CS Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor, Michigan
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17
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Sivridis E, Koukourakis IM, Arelaki S, Balaska K, Karpouzis A, Giatromanolaki A. Patterns of LC3A Autophagy Protein Expression in Keratoacanthomas. Head Neck Pathol 2019; 14:150-155. [PMID: 30977096 PMCID: PMC7021871 DOI: 10.1007/s12105-019-01033-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 03/18/2019] [Indexed: 11/29/2022]
Abstract
To investigate the expression patterns of autophagy marker light chain protein 3 (LC3A) in keratoacanthoma (KA). KAs are generally regarded as benign but malignant behavior, including rare metastases, may occur. 85 KAs were assessed for the LC3A autophagic protein by immunohistochemistry. Diffuse cytoplasmic staining and a "stone-like structure" (SLS) characterized positive expression. Thirty-four out of 85 KAs (40%) had diffuse cytoplasmic LC3A immunostaining (percentage of positive cells ranging from 5 to 60%). In contrast, only 4 of the 85 KAs (4.7%) expressed SLSs. Only one SLS was detected per histologic section of each tumor. The p53 oncoprotein was encountered in all cases with expression ranging from 1 to 90% of cells (median 30%). The Ki-67 index was expressed in 63 cases (74% of cases; range 1-50% of cells; median value 5%). Neither of these two parameters nor diffuse cytoplasmic LC3A staining was significantly correlated with SLS expression or lack thereof. Expression of SLSs, a hallmark of malignancy, was found in 4.7% of KAs. Further study is necessary to determine whether this fraction represents the exceptional cases that harbor latent malignant potential.
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Affiliation(s)
- Efthimios Sivridis
- Departments of Pathology, Democritus University of Thrace Medical School and University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece
| | - Ioannis M. Koukourakis
- Departments of Pathology, Democritus University of Thrace Medical School and University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece
| | - Stella Arelaki
- Departments of Pathology, Democritus University of Thrace Medical School and University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece
| | - Kostantina Balaska
- Departments of Pathology, Democritus University of Thrace Medical School and University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece
| | - Antonios Karpouzis
- Departments of Dermatology, Democritus University of Thrace Medical School and University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece
| | - Alexandra Giatromanolaki
- Departments of Pathology, Democritus University of Thrace Medical School and University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece
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18
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Ambati SR, Slotkin EK, Chow-Maneval E, Basu EM. Entrectinib in Two Pediatric Patients With Inflammatory Myofibroblastic Tumors Harboring ROS1 or ALK Gene Fusions. JCO Precis Oncol 2018; 2:https://ascopubs.org/doi/10.1200/PO.18.00095. [PMID: 31763577 PMCID: PMC6874363 DOI: 10.1200/po.18.00095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Srikanth R. Ambati
- Srikanth R. Ambati, Emily K. Slotkin, and
Ellen M. Basu, Memorial Sloan Kettering Cancer Center, New
York, NY; and Edna Chow-Maneval, Ignyta, San Diego, CA
| | - Emily K. Slotkin
- Srikanth R. Ambati, Emily K. Slotkin, and
Ellen M. Basu, Memorial Sloan Kettering Cancer Center, New
York, NY; and Edna Chow-Maneval, Ignyta, San Diego, CA
| | - Edna Chow-Maneval
- Srikanth R. Ambati, Emily K. Slotkin, and
Ellen M. Basu, Memorial Sloan Kettering Cancer Center, New
York, NY; and Edna Chow-Maneval, Ignyta, San Diego, CA
| | - Ellen M. Basu
- Srikanth R. Ambati, Emily K. Slotkin, and
Ellen M. Basu, Memorial Sloan Kettering Cancer Center, New
York, NY; and Edna Chow-Maneval, Ignyta, San Diego, CA
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19
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Torres US, Matsumoto C, Maia DR, de Souza LRMF, D'Ippolito G. Computed Tomography and Magnetic Resonance Imaging Findings of Inflammatory Pseudotumors in the Abdomen and Pelvis: Current Concepts and Pictorial Review. Semin Ultrasound CT MR 2018; 39:220-229. [PMID: 29571557 DOI: 10.1053/j.sult.2017.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The group of inflammatory pseudotumors (IPTs) encompasses a variety of rare neoplastic and nonneoplastic entities described to occur in almost every location in the body and whose clinical features and aggressive imaging findings (varying from infiltrative to mass-forming lesions), frequently mimic those of malignant tumors. The radiologic features of IPTs are variable and nonspecific, the imaging findings depending on the body location and involved organ. Abdominopelvic IPTs are rare and the purposes of this review, therefore, are to familiarize the radiologist with the wide spectrum of computed tomography and magnetic resonance imaging findings of IPTs in various locations throughout the abdomen and pelvis, discussing the imaging features that allow consideration of IPTs in the differential diagnosis of soft-tissue masses within the pertinent clinical setting. Radiologists should be aware of this group of entities, as a preoperative histopathologic diagnosis upon radiological suspicion may help to differentiate IPTs from malignancy and to allow the most appropriate clinical work-up for these patients.
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Affiliation(s)
| | - Carlos Matsumoto
- Grupo Fleury, São Paulo, Brazil; Department of Imaging, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | - Giuseppe D'Ippolito
- Grupo Fleury, São Paulo, Brazil; Department of Imaging, Universidade Federal de São Paulo, São Paulo, Brazil
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20
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Abstract
The normal peritoneal structures, including the mesenteries and the omenta, are only a few cell layers thick and are visible on imaging based upon the tissues (e.g., fat) and structures (e.g., blood vessels and lymph nodes) contained within them. These structures become more visible and change in appearance when involved by pathological processes. In this pictorial essay, we discuss the normal anatomy of the various abdominopelvic peritoneal structures and illustrate numerous developmental and acquired diagnoses that involve these structures in the pediatric and young adult population.
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21
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Winant AJ, Schooler GR, Concepcion NDP, Lee EY. Current Updates on Pediatric Pulmonary Infections. Semin Roentgenol 2017; 52:35-42. [DOI: 10.1053/j.ro.2016.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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22
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D'Cunha A, Jehangir S, Thomas R. Inflammatory Myofibroblastic Tumor of Common Bile Duct in a Girl. APSP J Case Rep 2016; 7:28. [PMID: 27672578 PMCID: PMC5027059 DOI: 10.21699/ajcr.v7i4.445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 06/12/2016] [Indexed: 12/25/2022] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare, low grade malignant lesion which can occur anywhere in the body. In children it is usually found in the visceral soft tissues with a potential for local invasion and recurrence, and rarely distant metastasis. We report the diagnostic dilemma faced in the management of a 12-year old girl who presented with obstructive jaundice with a mass lesion at the distal end of the common bile duct. She underwent a tumor resection with a bilio-enteric bypass followed by a course of oral steroids and celecoxib.
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Affiliation(s)
- Aureen D'Cunha
- Department of Pediatric Surgery, Christian Medical College, Vellore,INDIA
| | - Susan Jehangir
- Department of Pediatric Surgery, Christian Medical College, Vellore,INDIA
| | - Reju Thomas
- Department of Pediatric Surgery, Christian Medical College, Vellore,INDIA
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