Pulmonary inflammatory myofibroblastic tumor and IgG4-related inflammatory pseudotumor: a diagnostic dilemma.

IgG4-related inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT) share morphological features like a prominent fibroblastic/myofibroblastic proliferation and the presence of inflammatory cells. Since IPT is managed conservatively and IMT is treated by surgical excision, it is...

Descripción completa

Detalles Bibliográficos
Publicado en:Virchows Archiv: European Journal of Pathology Vol. 463; no. 6; pp. 743 - 748
Autores principales: Bhagat, Priyanka, Bal, Amanjit, Das, Ashim, Singh, Navneet, Singh, Harkant
Formato: research Journal Article
Publicado: Springer Nature Dec2013
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104119826&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 104119826
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        09456317
        O1Z
      jtl: Virchows Archiv: European Journal of Pathology
      issn: 09456317
      maglogo: N
    pubinfo:
      dt: Dec2013
      vid: 463
      iid: 6
      pid: 237
      pub: Springer Nature
      place: New York, New York
    artinfo:
      ui:
        104119826
        NLM24100523
        2012399819
        10.1007/s00428-013-1493-2
        NLM24100523
        104119826
      ppf: 743
      ppct: 5
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: Pulmonary inflammatory myofibroblastic tumor and IgG4-related inflammatory pseudotumor: a diagnostic dilemma.
      aug:
        au:
          Bhagat, Priyanka
          Bal, Amanjit
          Das, Ashim
          Singh, Navneet
          Singh, Harkant
        affil: Department of Histopathology, Post Graduate Institute of Medical Sciences & Research (PGIMER), Sector - 12, Chandigarh, 160012, India.
      sug:
        subj:
          Diagnosis, Differential
          Lung Neoplasms Diagnosis
          Neoplasms, Muscle Tissue Diagnosis
          Lung Diseases Diagnosis
          Adolescence
          Adult
          Child
          Female
          Human
          Immunoglobulins
          Immunohistochemistry
          Inflammation Diagnosis
          Inflammation Metabolism
          Lung Neoplasms Metabolism
          Male
          Middle Age
          Neoplasms, Muscle Tissue Metabolism
          Lung Diseases Metabolism
          Retrospective Design
          Adolescent: 13-18 years
          Adult: 19-44 years
          Child: 6-12 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: IgG4-related inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT) share morphological features like a prominent fibroblastic/myofibroblastic proliferation and the presence of inflammatory cells. Since IPT is managed conservatively and IMT is treated by surgical excision, it is important to differentiate these two lesions. The aim of this study is to highlight morphological and immunohistochemical features that distinguish IPT and IMT. Clinicopathological characteristics of cases diagnosed as pulmonary IPT or IMT from 1997 to 2013 were reviewed. The histological features were studied on hematoxylin and eosin-stained sections. Immunohistochemistry was done for IgG, IgG4, ALK-1, SMA, desmin, and CD34 for classification into IPT and IMT. Of the ten patients, seven were male and the age ranged from 4 to 58 years. The tumor size ranged from 1.5 to 4.0 cm in diameter. Histologically, proliferation of bland-looking spindle cells along with fibrosis and an inflammatory infiltrate comprising of lymphocytes and plasma cells were the common morphological features of both lesions. The spindle cell proliferation was more marked in IMT whereas lymphoplasmacytic infiltrate was more prominent in IPT. Obstructive phlebitis was observed only in cases of IPT. IgG4 expression was noted in IPT, and the number of IgG4-positive plasma cells and the ratio of IgG4+/IgG+ plasma cells were significantly lower in IMT than in IgG4-related IPT. Expression of anaplastic lymphoma kinase (ALK) was observed only in IMT, but not in IgG4-related IPT. The proportion of proliferating spindle cells, lymphoplasmacytic infiltrate, obstructive phlebitis, IgG4+ plasma cells and the ratio of IgG4+/IgG+ plasma cells, and ALK expression are helpful in differentiating these morphologically similar but biologically different lesions, which require different treatment modalities.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N