Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Inflammatory myofibroblastic tumor.
- Radiologic Findings
- Posteroanterior chest radiograph shows a well-defined opacity in the retro cardiac area. Contrast-enhanced CT images show a well-defined mass with heterogeneous enhancement and adjacent engorged vessels in the left lower lobe. On FDG-PET, it reveals slightly high FDG uptake. She underwent left lower lobectomy.
- Brief Review
- Inflammatory myofibroblastic tumor refers to an unusual inflammatory reaction with a variable histologic appearance. Histologically, it consists of a mixture of inflammatory cells, myofibroblastic spindle cells, and plasma cells. Radiologic manifestations consist of either a solitary pulmonary nodule or a focal area of consolidation. On CT, inflammatory myofibrolastic tumor has smooth, lobulated margins, homogeneous or heterogeneous attenuation following intravenous administration of contrast medium. On PET, it usually shows high uptake indicating a high degree of metabolic activity. The radiologic differential diagnosis includes primary or secondary neoplasm and granuloma. The biologic potential of inflammatory myofibroblastic tumor varies. Complete surgical resection is the treatment of choice. Local recurrence may occur in some cases even after complete surgical resection.
- References
- 1. Kovach SJ, Fischer AC, Katzman PJ, Salloum RM, Ettinghausen SE, Madeb R, Koniaris LG. Inflammatory myofibroblastic tumors. J Surg Oncol. 2006 Oct 1;94(5):385-91.
2. Coffin CM, Hornick JL, Fletcher CD. Inflammatory myofibroblastic tumor: comparison of clinicopathologic, histologic, and immunohistochemical features including ALK expression in atypical and aggressive cases. Am J Surg Pathol. 2007 Apr;31(4):509-20.
3. Gim챕nez A, Franquet T, Prats R, Estrada P, Villalba J, Bagu챕 S. Unusual primary lung tumors: a radiologic-pathologic overview. Radiographics. 2002 May-Jun;22(3):601-19.
4. Takeda S, Onishi Y, Kawamura T, Maeda H. Clinical spectrum of pulmonary inflammatory myofibroblastic tumor. Interact Cardiovasc Thorac Surg. 2008 Aug;7(4):629-33.
- Please refer to
- Case 94 Case 489 Case 516
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- Keywords
- lung, benign tumor,