Inflammatory Myofibroblastic Tumor Mimicking Anterior Mediastinal Malignancy

Chen, Chih‐Hao; Lin, Rong-Luh; Liu, Hung-Chang; Chen, Chao-Hung; Hung, Tzu-Ti; Huang, Wen‐Chien

doi:10.1016/j.athoracsur.2008.03.031

Cited by 22 publications

(19 citation statements)

References 8 publications

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“…These appearances are nonspecific and may resemble numerous other causes of tracheobronchial neoplasms. When IMTs are located within the mediastinum, local invasion of adjacent structures may occur, 16 as seen in the presented case. Spontaneous regression of a mediastinal IMT has been reported.…”

Section: Thoracic Ctmentioning

confidence: 76%

The Thoracic Mass

Gotway¹

2009

Clinical Pulmonary Medicine

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Inflammatory myofibroblastic tumor (IMT) is a rare proliferative lesion also known as inflammatory pseudotumor. IMTs consist of variable amounts of spindle cells, collagen, and inflammatory cells, including plasma cells, foamy histiocytes, and lymphocytes. IMTs have been reported in numerous organ systems, but most commonly are encountered within the thorax, usually the lung or tracheobronchial tree, and uncommonly the mediastinum.IMTs show variable biological behavior, ranging from spontaneous regression to locally aggressive behavior, including recurrence after resection and even distant metastatic disease. Genetic analysis has shown features consistent with true neoplasia in some IMTs, but not others; these observations, and the variable biological behavior of these lesions, make them difficult to properly classify.Pulmonary IMTs occur over a wide age range, but are most commonly encountered in children, adolescents, or young adults. These lesions are often discovered asymptomatically but may present fever, chest pain, dyspnea, or hemoptysis-these latter 2 symptoms may be more frequently encountered in airway lesions.The imaging findings of thoracic IMT primarily consist of a solitary pulmonary nodule or mass, which may show calcification-this appearance, in a young patient, while not pathognomonic, suggests IMT.The margins of thoracic IMTs may be smoothly circumscribed or lobulated or poorly defined. These lesions often show intense contrast enhancement and may even be associated with aberrant systemic arterial supply, resembling pulmonary sequestration.The treatment of choice for thoracic IMT is limited surgical resection, with corticosteroid therapy or radiation reserved for unresectable patients or patients with inadequate surgical margins.

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Section: Thoracic Ctmentioning

confidence: 76%

The Thoracic Mass

Gotway¹

2009

Clinical Pulmonary Medicine

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“…An inflammatory pseudotumor arising solely in the mediastinum is very rare, and few cases have been reported (2, 3). Among the reported, only one case included 18 F-FDG PET/CT images (2).…”

Section: Discussionmentioning

confidence: 99%

“…Inflammatory pseudotumor arising purely in the mediastinum is very rare, with only few reported cases in the literature (2, 3). Furthermore, there is only one case presenting the disease with 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) (2).…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Pseudotumor in the Mediastinum: Imaging with¹⁸F-Fluorodeoxyglucose PET/CT

Yoon

Lee

et al. 2013

Korean J Radiol

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“…Pleural manifestation of IMT is rare. There are some cases with pulmonary nodules attached to the pleura, mediastinal lesions with pleural involvement, but to our knowledge such a large pleural lesion has yet not been described [7–10]. It is currently unclear whether IMTs represent a primary inflammatory process versus an underlying low-grade malignancy with a prominent inflammatory response [2, 3].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Challenges of a Large Pleural Inflammatory Myofibroblastic Tumor

Löffler‐Ragg

Bodner

Freund

et al. 2012

Case Reports in Pulmonology

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We report a 48-year-old woman with a pleural pseudoneoplasm requiring different diagnostic and therapeutic strategies. After initial presentation with increasing dyspnoea, temperature, dry cough, and interscapular pain diagnostic processing showed a large mediastinal mass with marked pleural effusion and high metabolic activity in the 18F-FDG-PET/CT. Extensive CT-guided biopsy of the tumor reaching from the visceral pleura into the right upper lobe revealed no malignancy, but a marked inflammatory tissue reaction containing foam cells. Initial empiric antibiotic therapy was temporarily successful. However, in the further course the mass relapsed and was resistant to antibiotics and a corticosteroid trial. With the working hypothesis of an inflammatory myofibroblastic tumor the patient underwent surgical tumor resection, finally confirming the suspected diagnosis. Due to residual disease intravenous immunoglobulins were administered leading to sustained response. This case with a pleural localisation of a large inflammatory pseudotumor with responsiveness to immunomodulation after incomplete resection extends the reported spectrum of thoracopulmonary manifestations of this rare entity.

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Inflammatory Myofibroblastic Tumor Mimicking Anterior Mediastinal Malignancy

Cited by 22 publications

References 8 publications

The Thoracic Mass

The Thoracic Mass

Inflammatory Pseudotumor in the Mediastinum: Imaging with¹⁸F-Fluorodeoxyglucose PET/CT

Diagnostic and Therapeutic Challenges of a Large Pleural Inflammatory Myofibroblastic Tumor

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Inflammatory Myofibroblastic Tumor Mimicking Anterior Mediastinal Malignancy

Cited by 22 publications

References 8 publications

The Thoracic Mass

The Thoracic Mass

Inflammatory Pseudotumor in the Mediastinum: Imaging with18F-Fluorodeoxyglucose PET/CT

Diagnostic and Therapeutic Challenges of a Large Pleural Inflammatory Myofibroblastic Tumor

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Inflammatory Pseudotumor in the Mediastinum: Imaging with¹⁸F-Fluorodeoxyglucose PET/CT