Inflammatory pseudotumors of the central nervous system

Lui, Pauline Po Yee; Fan, Yuen Shan; Wong, Steve S; Chan, Alice; Wong, Gary K. W.; Chau, Tony K.F.; Tse, Gary; Cheng, Yue; Poon, Wai-sang; Ng, Ho Keung

doi:10.1016/j.humpath.2009.04.016

Cited by 69 publications

(65 citation statements)

References 26 publications

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“…In light of these studies, we evaluated three inflammatory pseudotumors from our archives for IgG4 expression, and we did not find significant numbers of IgG4-positive cells in any of these three cases (ranging from 8-10 IgG4/HPF; mild per criteria of Kamisawa et al 12 ), in contrast to the intracranial cases reported by Lui et al, 43 wherein three out of four cases showed a relative increase of IgG4-positive plasma cell in a rich inflammatory background.…”

Section: Discussionmentioning

confidence: 77%

Marginal zone lymphomas involving meningeal dura: possible link to IgG4-related diseases

et al. 2011

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Dura-based marginal zone lymphomas represent an uncommon group of low-grade B-cell neoplasms, and literature regarding the clinical, histological and genetic profile of these tumors in the context of the newly described IgG4-related entities is lacking. We analyzed 32 dura-based marginal zone lymphomas identified in 27 females and 5 males ranging in age from 33-82 years (median 50). Morphologic examination, immunohistochemical studies and PCR for B-cell clonality were carried out in all cases. In addition, IgG4 immunohistochemistry and cytogenetic studies (either by FISH or RT-PCR) were carried out in 20 (18 primary dural; 2 with associated extradural disease) and 9 cases, respectively. Clinically, most cases presented radiologically as dura-based masses, mimicking meningioma. Histologically, the majority exhibited plasmacytoid differentiation, and were clonal either by PCR or immunohistochemical light chain analysis (28 out of 32). In the subset tested for IgG4, 6 of 18 primary dural marginal zone lymphoma (including one epidural tumor) showed numerous IgG4-positive plasma cells; all 6 were light chain restricted and clonal by PCR in 5 of 6 tested cases. Three IgG4-positive marginal zone lymphomas tested for cytogenetics did not show any cytogenetic aberrations. Across all cases, FISH and RT-PCR identified abnormalities in three out of nine cases (trisomies 3 and 18; trisomies 3 and 1; trisomy 18) without any extranodal marginal zone lymphoma specific translocations. Regardless of the treatment modality, 16 of 17 patients with follow-up are alive without evidence of disease over a period of 4-124 months (median 19.5). The expression of IgG4 in light-chain-restricted clonal plasma cells of a significant subset of dural marginal zone lymphomas, including one in an epidural location, is a novel finding and points to distinctive biology. Cytogenetic aberrations are present only in a minority of dural marginal zone lymphomas.

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Section: Discussionmentioning

confidence: 77%

Marginal zone lymphomas involving meningeal dura: possible link to IgG4-related diseases

et al. 2011

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“…IgG4-related IPs have been discovered in lung, breast and other locations, [16][17][18] and were associated 15) Four cases had an inflammatory-cell rich pattern that did not express ALK, and none of these 4 cases recurred. 8) Although ALK expression was not examined in our case, the subtype of the case was inflammatory cell-rich type indicating the prognosis was likely to be better. No unified treatment protocol was been determined for intraventricular IPs or even intracranial IPs, due to the rarity.…”

Section: Discussionmentioning

confidence: 75%

“…Only 9 cases of IP in the ventricles have been reported in detail (Table 1), 1,4,5,8,10,11,13,14) occurring in 2 females and 7 males aged 15-73 years (mean 49 years), indicating a tendency to occur in middle-aged or older men. 10) Eight of 9 cases developed in the lateral ventricle, with the remaining case developing in the fourth ventricle.…”

Section: Discussionmentioning

confidence: 99%

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Inflammatory Pseudotumor in the Lateral Ventricle

Ohue

Kohno

Matsui

et al. 2012

Neurol. Med. Chir.(Tokyo)

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A 15-year-old boy was referred to our hospital with a rare case of inflammatory pseudotumor (IP) in the lateral ventricle manifesting as complaints of headache and low-grade fever. Computed tomography and magnetic resonance imaging demonstrated a well-demarcated and enhanced tumorous lesion in the right lateral ventricle. Intraoperative findings showed a hard mass with feeding arteries from the choroid plexus around the foramen of Monro in the right lateral ventricle, although the mass was not attached to the wall of the lateral ventricle. The lesion was totally resected, and the histopathological diagnosis was IP. The present and previous cases suggest that good outcomes are obtained by surgical removal and treatment of hydrocephalus. IP should be considered in the differential diagnosis of hard tumorous lesions with good enhancement and no tumorous staining in the ventricle.

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“…Inflammatory pseudotumors form a heterogenous disease group with an unsettled pathogenesis (11). The tumors contain fibrosis and inflammatory cells, with irregularly scattered infiltration by macrophages, plasma cells and lymphocytes, and are possibly as a result of inflammation.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory pseudotumor of the pineal region: First reported case

et al. 2016

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Abstract. Inflammatory pseudotumors originating in the central nervous system (CNS) are quite rare. To the best of our knowledge, the present study reports the first case of a inflammatory pseudotumor that developed in the pineal region, and describes the neuroimaging, morphological and immunohistochemical findings. A 53-year-old male presented with hearing loss that had been apparent for 1 year and blurred vision that had persisted for 10 months. Magnetic resonance imaging (MRI) demonstrated a homogeneously-enhanced mass in the pineal region and obstructive hydrocephalus. A pathological examination revealed that the lesion was comprised predominantly of spindled cells in a collagenous background, with dense infiltrates of small lymphocytes, plasma cells and uninucleated histiocytes. Immunopositivity for cluster of differentiation (CD)138 was noted. Immunohistochemical staining showed that the cells were immunonegative for glial fibrillary acidic protein, S-100, placental alkaline phosphatase, neurofilament and Pit-Oct-Unc class 5 homeobox 1. The Ki-67 labeling index was <5%. The lymphocytic infiltrates consisted of CD3-and CD43-positive T-cells, and CD20-and CD79A-positive B-cells. Plasma cells displayed polytypic reactivity for immunoglobulin κ and λ light chains. Based on the MRI and the morphological and immunohistochemical analysis, a diagnosis of an inflammatory pseudotumor was formed. The patient underwent a surgical resection of the tumor and currently has a good prognosis.

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Inflammatory pseudotumors of the central nervous system

Cited by 69 publications

References 26 publications

Marginal zone lymphomas involving meningeal dura: possible link to IgG4-related diseases

Marginal zone lymphomas involving meningeal dura: possible link to IgG4-related diseases

Inflammatory Pseudotumor in the Lateral Ventricle

Inflammatory pseudotumor of the pineal region: First reported case

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