Benign Histiocyte-Rich Pseudotumor Developing Postchemotherapy and Mimicking Residual Disease

Singh, Amrit Pal; Murray, Glenn; Pandey, Soumya

doi:10.1155/2020/4674103

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…In fact, chemotherapy can induce tumor necrosis and inflammatory response to phagocytize the dead necrotic tissue, which can increase metabolic activity in necrotic masses and cause a suspicious 18F-FDG uptake. These data underline the importance of defining these findings in the best and least invasive way possible [8] , [9] , [10] , [11] , [12] .…”

Section: Discussionmentioning

confidence: 95%

Ileal inflammatory pseudotumor in adolescent male patient with prior Burkitt lymphoma: A challenging diagnosis

Mainolfi

D’Antonio

Mango

et al. 2021

Radiology Case Reports

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Inflammatory pseudotumor is a rare benign mesenchymal pediatric neoplasm, that can mimic tumoral residue or relapse at metabolic imaging with nonspecific clinical presentation and difficult diagnosis. We present the case of a 14year old male patient with fever of unknown origin and large ileal mass, diagnosed with and treated for Burkitt lymphoma, who performed several 18-fluoro-deoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) scans, during and after first line chemotherapy, showing persistent and focal uptake, while ileal mass volume decreased dramatically and the patient was clinically asymptomatic. Histopathological analysis of residual ileal mass was suggestive for xanthomatous pseudotumor, a type of inflammatory pseudotumor. No more treatment was performed and a short-term follow up with 18F-FDG PET/CT showed tracer uptake intensity decreasing progressively over the next few months. This case reports an uncommon presentation of a rare disease, inflammatory pseudotumor of the small bowel developed at the site of treated Burkitt lymphoma, underscoring the potential role of 18F-FDG PET/CT imaging in the diagnosis and management of these rare neoplasms, particularly in asymptomatic patients.

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Section: Discussionmentioning

confidence: 95%

Ileal inflammatory pseudotumor in adolescent male patient with prior Burkitt lymphoma: A challenging diagnosis

Mainolfi

D’Antonio

Mango

et al. 2021

Radiology Case Reports

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“…Table 3 details the clinicopathologic and radiologic results of 23 patients previously reported in the literature [13][14][15][16][17][18][19][20][21][22][23]. In summary, PHP was identified by PET/CT, CT only or physical examination.…”

Section: Resultsmentioning

confidence: 99%

Post-Chemotherapy Histiocyte-Rich Pseudotumors: Radiologic and Endoscopic Mimics of Residual Lymphoma

et al. 2021

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Development of post-chemotherapy histiocyte-rich pseudotumor (PHP) is an underrecognized event following therapy in lymphoma patients and may mimic residual tumor using current therapy monitoring protocols. We report a series of 5 patients with PHP along with a review of the literature. In our series, we describe 3 patients with persistent hypermetabolic masses by positron emission tomography-computed tomography, one with persistent terminal ileal nodules on endoscopy, and one with bone marrow involvement, a site not associated with mass-like disease. Twenty-three patients with long-term follow-up were identified from our series and review of the literature. Forty-four percent of patients received additional therapy, and only 4% of patients died of lymphoma. This study illustrates that PHPs are not identified using current lymphoma therapy monitoring algorithms and may result in overtreatment with risk for additional therapy-related complications. The need for confirmatory tissue biopsy in this setting is recommended.

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“…Xanthomatous pseudotumor or xanthogranulomatous changes following chemotherapy have been described. As a response to chemotherapeutic agents, tumor in multiple anatomical locations, such as the gastrointestinal tract, 17 spleen, 18 breast, 19 and skin 20 can form xanthomatous pseudotumor, composed of tumor necrosis and lipid laden macrophages.…”

Section: Discussionmentioning

confidence: 99%

Clear Cell Renal Cell Carcinoma with Immunotherapy Effect Mimicking Xanthogranulomatous Pyelonephritis

et al. 2022

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Renal cell carcinoma is now increasingly treated with checkpoint inhibitor therapy, predominantly in the metastatic setting or occasionally in the adjuvant setting; however, there is little published histopathology data demonstrating the post-therapy features of renal cell carcinoma tumor tissue. We report a middle-aged man, who was undergoing treatment with pembrolizumab for locally recurrent cutaneous basal cell carcinoma and was incidentally found to have a renal mass. Radical nephrectomy demonstrated a 5.0 cm renal mass with extensive xanthogranulomatous features, mimicking xanthogranulomatous pyelonephritis. However, rare clusters of cells demonstrated gland-like lumina, clear cytoplasm, and slightly increased atypia, suggesting scant residual renal cell carcinoma cells. Immunohistochemistry demonstrated focal positivity for pan-keratin and keratin 8/18, EMA, PAX8, CD10, and carbonic anhydrase 9 (CA9), supporting a diagnosis of renal cell carcinoma with extensive treatment response, to the point that it mimicked xanthogranulomatous pyelonephritis. This report demonstrates the histologic features of post-immunotherapy renal cell carcinoma, aiding pathologists in recognition of this phenomenon, which may be misdiagnosed as an inflammatory process, if immunotherapy was performed for other reasons.

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Benign Histiocyte-Rich Pseudotumor Developing Postchemotherapy and Mimicking Residual Disease

Cited by 3 publications

References 29 publications

Ileal inflammatory pseudotumor in adolescent male patient with prior Burkitt lymphoma: A challenging diagnosis

Ileal inflammatory pseudotumor in adolescent male patient with prior Burkitt lymphoma: A challenging diagnosis

Post-Chemotherapy Histiocyte-Rich Pseudotumors: Radiologic and Endoscopic Mimics of Residual Lymphoma

Clear Cell Renal Cell Carcinoma with Immunotherapy Effect Mimicking Xanthogranulomatous Pyelonephritis

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