Inflammatory Myofibroblastic Tumour of Thyroid with its Prominent Spindle Cell Pattern: A Rare Case Report

Abstract

A 61-year-old male patient presented with painless thyroid swelling for 2 years duration. He was clinically euthyroid and his thyroid profile was normal. Ultrasound showed hypo echoic thyroid mass in the right lobe with cystic degeneration. FNAC [ Inflammatory myofibroblastic tumour of thyroid is very rare. Only 18 cases reported so far. Here we report a case of Inflammatory myofibroblastic tumour with its prominent spindle cell (fibrohistiocytic) pattern in a 61-year-old male patient. The dominant histological pattern in our case was myofibroblastic in contrast to prominent lymphoplasmocytic pattern in other previously reported cases. The tumour was strongly positive for vimentin, Anaplastic lymphoma kinase and showed focal positivity for Smooth Muscle Actin. The patient was treated with total thyroidectomy and he is comfortable after surgery.showed gray white firm areas with focal cystic change, diffusely involving the entire thyroid specimen. There was no normal thyroid tissue. Tissue sections were routinely processed and stained with Haematoxylin and Eosin.

ALK-1-positive inflammatory myofibroblastic tumor of the thyroid complicated by Hashimoto’s thyroiditis: report of a rare case and a literature review

“…We found from our search of the English literature using the term IMTs of the thyroid, that there were 22 such reported cases. For all, the diagnosis was PCG and only five cases involved IMTs or inflammatory pseudotumors [13,[21][22][23][24]. These reports indicated that IMTs of the thyroid differ from those at other anatomic sites and are often negative for ALK-1.…”

Plasma Cell Granuloma of the Thyroid: Review of an Uncommon Entity

“…3,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] We found 3 cases (cases 19-21 in Table 1) reported as IMT of the thyroid (IMT-T) that were lesions containing predominantly myofibroblastic proliferation with an associated polymorphous inflammatory infiltrate. [21][22][23] The clinicopathologic features are summarized in Table 1. Comparison of clinicopathologic characteristics of PCG-T and IMT-T is summarized in Table 2.…”

“…6 On fine-needle aspiration in IMT-T, 1 case each was reported as epithelioid neoplasm (case 19) 21 and spindle cell proliferation (case 21). 23…”

“…3,19,20 ALK IHC was negative in 2 of 3 cases of IMT-T (cases 19 and 20) 21,22 and positive in 1 case (case 21). 23 In the IMT-T reported as ALK IHC positive (case 21), FISH or molecular testing for ALK gene rearrangement was not performed. 23 ALK IHC is neither sensitive nor specific for IMT, as only approximately 50% of IMTs have the rearrangement and ALK IHC can be positive in other soft tissue tumors.…”

“…23 In the IMT-T reported as ALK IHC positive (case 21), FISH or molecular testing for ALK gene rearrangement was not performed. 23 ALK IHC is neither sensitive nor specific for IMT, as only approximately 50% of IMTs have the rearrangement and ALK IHC can be positive in other soft tissue tumors. 1 These cases were categorized as IMT-T by histopathologic features, as almost 50% of IMTs lacked molecular aberrations.…”