Inflammatory pseudotumors of the central nervous system: Report of 3 cases and a literature review

Häusler, Martin; Schaade, Lars; Ramaekers, Vincent; Doenges, Martin; Heimann, G.; Sellhaus, Bernd

doi:10.1053/hupa.2003.35

Cited by 115 publications

(126 citation statements)

References 33 publications

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“…7) The lesions in the spinal cord are also mainly dura-based (45%) and rarely intraaxial (27%). 3,17) In our case, the lesions were located in parietal lobe near the left trigone and the intramedullary cervical spinal cord.…”

Section: Discussionmentioning

confidence: 99%

Immunohistochemical Study of Multiple Inflammatory Pseudotumors With Both Brain and Spinal Cord Involvement -Case Report-

Ishihara

Izumoto

Iwatsuki

et al. 2010

Neurol. Med. Chir.(Tokyo)

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A 55-year-old man presented with a rare case of both intracranial and intraspinal inflammatory pseudotumors manifesting as progressive motor weakness in his lower extremities. Magnetic resonance imaging revealed a 24-mm diameter tumor-like lesion in the left parietal lobe and an intramedullary 24-mm diameter lesion at the C7 and T1 levels of the spinal cord. These lesions were resected by sequential operations. Histological examination of the resected lesions revealed the presence of excessive collagen fibers infiltrated with polyclonal lymphocytes and plasma cells, and the diagnosis was inflammatory pseudotumor. Immunohistochemical staining with anti-immunoglobulin G4 (IgG4) antibody found no accumulation of IgG4-positive cells. The serum IgG4 level was normal. Thus, this case did not meet the criteria for IgG4-related disease.

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Section: Discussionmentioning

confidence: 99%

Immunohistochemical Study of Multiple Inflammatory Pseudotumors With Both Brain and Spinal Cord Involvement -Case Report-

Ishihara

Izumoto

Iwatsuki

et al. 2010

Neurol. Med. Chir.(Tokyo)

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“…Although the central nervous system is the rare site affected by IMTs, more over 100 sporadic cases have been reported in the literatures [11,26], but intraspinal IMTs were extremely rare. Except our own case, 13 cases of intraspinal IMT have been reported in the literatures.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory myofibroblastic tumor in the intradural extramedullary space of the lumbar spine with spondylolisthesis: case report and review of the literature

et al. 2009

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“…6 A reported 15-30% of patients have a clinical and laboratory syndrome of fever, malaise, weight loss, anemia, elevated erythrocyte sedimentation rate, thrombocytosis, polyclonal hypergammaglobulinemia, and other inflammatory marker elevations. [7][8][9][10][11][12][13] IgG4-related sclerosing disease (IgG4SD) is a steroid-responsive multiorgan system disorder that encompasses a spectrum of clinical conditions, includ ing autoimmune pancreatitis, sclerosing cholangitis, chronic sclerosing sialadenitis, tubulointerstitial nephritis, cutaneous pseudolymphoma, and sclerosing processes in the lung and pleura, liver, breast, and meninges. 5,[14][15][16][17] The histological findings of fibrosis and chronic inflammation are relatively nonspecific, and there are no known unique genetic markers.…”

mentioning

confidence: 99%

IgG4 plasma cells in inflammatory myofibroblastic tumor: inflammatory marker or pathogenic link?

et al. 2011

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Inflammatory myofibroblastic tumor is a rare mesenchymal neoplasm that harbors an anaplastic lymphoma kinase (ALK) gene rearrangement in the majority of cases. It is composed of fibroblastic-myofibroblastic cells with a characteristic inflammatory infiltrate that consists predominantly of plasma cells. In contrast, IgG4-related sclerosing disease is a recently described multisystem disorder with a histological appearance similar to inflammatory myofibroblastic tumor. The plasma cell infiltrate is characteristic in IgG4-related sclerosing disease and has been studied as a tool to render this diagnosis. Histologically, the two disorders overlap, although there are significant clinical differences. This study analyzes the histological appearance of 36 inflammatory myofibroblastic tumors, compares them with IgG4-related sclerosing disease, and assesses the plasma cell profile using immunohistochemistry to determine the range and proportion of IgG4 plasma cells. The majority of patients were children and young adults, mainly with solitary masses and no clinical manifestations of IgG4-related sclerosing disease. ALK-1 positivity was present in 23 cases (64%). None showed obliterative phlebitis or prominent lymphoid aggregates. Of 36 inflammatory myofibroblastic tumors, 15 cases showed an IgG4/IgG ratio Z0.10, a cutoff described in the literature as supportive of IgG4-related sclerosing disease and up to 33 IgG4-positive plasma cells per high-power field indicating a mild-to-moderate increase as compared with IgG4-related sclerosing disease. Currently, the diagnostic recognition of inflammatory myofibroblastic tumor is based on clinicopathological features and diagnostic adjuncts, such as ALK-1 reactivity and genetic tests. Although inflammatory myofibroblastic tumor and IgG4-related sclerosing disease are distinct entities, a subset of inflammatory myofibroblastic tumors exhibit an IgG4/IgG ratio that is within the range for IgG4-related sclerosing disease. Therefore, the ratio alone cannot be used as a reliable discriminator between these two entities and other clinical and pathologic features must always be taken into account.

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Inflammatory pseudotumors of the central nervous system: Report of 3 cases and a literature review

Cited by 115 publications

References 33 publications

Immunohistochemical Study of Multiple Inflammatory Pseudotumors With Both Brain and Spinal Cord Involvement -Case Report-

Immunohistochemical Study of Multiple Inflammatory Pseudotumors With Both Brain and Spinal Cord Involvement -Case Report-

Inflammatory myofibroblastic tumor in the intradural extramedullary space of the lumbar spine with spondylolisthesis: case report and review of the literature

IgG4 plasma cells in inflammatory myofibroblastic tumor: inflammatory marker or pathogenic link?

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