Intranodal Palisaded Myofibroblastoma: Radiological and Cytological Overview

Altınbaş, Namık Kemal; Öz, İlker; Üstüner, Evren; Gülpınar, Başak; Peker, Elif; Akkaya, Zehra; Peker, Ahmet; Ceyhan, Koray; Yağcı, Cemil

doi:10.12659/pjr.895743

Cited by 9 publications

(9 citation statements)

References 29 publications

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“…Spindle cells are stained with smooth muscle actin (SMA), muscle-specific actin and vimentin. It is known that actin (+), desmin (-) myofibroblasts are more frequent in inguinal lymph nodes as compared to other sites and this finding supports the predilection of this tumor for inguinal region 5,19,20 . Desmin, c-kit (CD117), carcinoembryonic antigen, keratins, CD34, calponin, S-100, HMB-45, and EBV latent membrane protein, herpes simplex virus (HSV) type II and human papilloma virus (HPV) are found to be negative in spindle cells (1,13,23) .…”

Section: Histochemical and Immunohistochemical Featuressupporting

confidence: 74%

“…Myofibroblasts and/or smooth muscle cell of lymph nodes are the origin of this unique entity 5,6,19,20 . Vimentin, actin and amianthoid fibers factor XIIIa are found to be positive while desmin is negative 6,8 .…”

Section: Cell Of Originementioning

confidence: 99%

“…Sono-elastography has been proposed with promising and has been reported as useful for differentiating from malignant lesions in some tissues, such as breast, thyroid, salivary gland, and lymph node [34][35][36][37] . However elastographic findings have been reported in a case with IPM and it has been found that sonographic features, including spectral Doppler analysis and elastography, are useless for diagnosis of this rare tumor 19 . Computed tomography can be performed to exclude the other mass lesions.…”

Section: Imagingmentioning

confidence: 99%

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İntranodal Palisad Myofibroblastoma: Klinisyenler ve Patologlar için Histopatolojik ve Klinik İnceleme

Paydaş

2021

Arşiv Kaynak Tarama Dergisi

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Intranodal palisaded myofibroblastoma (IPM) is a kind of mesenchymal tumor with benign behaviour. The origin of this tumor is differentiated smooth muscle cells and myofibroblasts. This is a rare entity and differential diagnosis from malignant tumors is important for clinicians and pathologists. The etiology has not been explained adequately. Age range is between 2nd and 8th decades of the life and it is seen more frequently in males. Inguinal region is the most common localization but has been reported in other localizations including submandibular and retroperitoneal areas. Total excision of the tumor is the treatment in these cases. Recurrence is very rare and there is no report about metastasis. In conclusion IPM is a rare entity and it is commonly misdiagnosed as metastasis. Kaposi Sarcoma and schwannoma are the most common two spindle cell neoplasias. Be aware of this unique entity is important because wrong diagnosis causes dangerous management strategies.

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Section: Histochemical and Immunohistochemical Featuressupporting

confidence: 74%

Section: Cell Of Originementioning

confidence: 99%

Section: Imagingmentioning

confidence: 99%

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İntranodal Palisad Myofibroblastoma: Klinisyenler ve Patologlar için Histopatolojik ve Klinik İnceleme

Paydaş

2021

Arşiv Kaynak Tarama Dergisi

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“…Color Doppler ultrasound defines a single vascular pole, supportive of a benign tumor. CT scan shows a well-demarcated tumor separate from adjacent structures [ 15 ]. Most IPMs are subcutaneous and amenable to cytological assessment using fine needle aspiration technique [ 15 ], which presents diagnostic challenges for the inexperienced cytopathologist as cellular pigmented areas can be confused with other soft-tissue tumors, such as schwannomas or, more concerningly, sarcomas and melanomas.…”

Section: Discussionmentioning

confidence: 99%

Intranodal Palisaded Myofibroblastoma: A Diagnostic Differential for Inguinal Lymphadenopathy

Haddad

Marwan

2021

Am J Case Rep

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Patient: Male, 48-year-old Final Diagnosis: Intranodal palisaded myofibroblastoma Symptoms: Inguinal lump Medication: — Clinical Procedure: Lumpectomy Specialty: Pathology • Surgery Objective: Rare disease Background: Benign tumors of the lymph nodes are rare and are not usually considered in the differential diagnosis in cases of lymphadenopathy because reactive hyperplasia, lymphoma, and metastatic carcinoma are the most likely causes of enlarged nodes. Intranodal palisaded myofibroblastoma (IPM) is a very rare benign mesenchymal tumor of the lymph nodes most often affecting but not limited to the inguinal region, with up to 92 cases reported in the English literature. The cell of origin is the intranodal differentiated smooth muscle cell or myofibroblast. Although the pathophysiology of IPM remains unclear, theories about viral oncogenesis and mutational changes in the β-catenin gene with subsequent abnormal expression of β-catenin and cyclin D1 have been raised. Case Report: We report a case of IPM in a 48-year-old man who presented with a mass in the left groin, with inconclusive imaging. The typical histologic findings of smooth muscle actin, cyclin D1, and β-catenin positive intranodal spindle cell proliferation with characteristic palisades, amianthoid fibers, collagenous bodies, lack of atypia, and very low mitotic count, together with characteristic profile on ancillary testing, confirmed the diagnosis. In addition to staining with smooth muscle actin, cyclin D1 and β-catenin, immunohistochemical studies showed focal positivity with desmin, a finding previously reported in 2 of the published cases. Surgical excision is usually curative, with a 6% recurrence rate and no reported cases of locally aggressive disease or malignant transformation. Conclusions: Although rare, IPM should be included in the differential diagnosis of isolated lymphadenopathy.

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“…However, several features have been described to distinguish lymph nodes from adenomas. While a benign reactive lymph node usually has an echogenic fatty hilum supplied by small hilar vessels, a parathyroid adenoma usually has a polar, peripheral vascular structure supplied by an extrathyroidal feeding vessel (1,6,11,12) . High-resolution ultrasonography findings, together with laboratory findings and other imaging methods, have an impressive value for the diagnosis of parathyroid lesions.…”

Section: Discussionmentioning

confidence: 99%

Sonoelastographic evaluation for benign neck lymph nodes and parathyroid lesions

Altınbaş

Yağcı

2018

J Ultrason

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Aim: The aim of the study was to evaluate the performance of real-time strain sonoelastography for comparison of perithyroidal lymph nodes of Hashimoto thyroiditis patients, jugular lymph nodes of healthy individuals and parathyroid lesions. Material and methods: Fifty parathyroid lesions (Group 1), 52 lymph nodes in Hashimoto thyroiditis patients (Group 2) and 51 reactive jugular lymph nodes (Group 3) were examined by ultrasound, and elastography was performed for a total of 95 patients. Real-time strain sonoelastography using elasticity score (E-index) was performed. The differences in E-index between the three groups were evaluated. Results: The mean E-index and size of parathyroid lesions were 2.30 ± 0.91 and 13.46 ± 5.69 mm, respectively. Parathyroid hyperplasia was detected by parathyroidectomy in two patients (2/37; 5%) with a total of four lesions (4/50; 8%). The remaining lesions were considered as adenomas. The mean E-index and size in Group 2 were 2.70 ± 0.93 and 7.83 ± 3.35 mm, respectively. The mean E-index and size in Group 3 were 1.88 ± 0.59 and 11.60 ± 4.96 mm, respectively. There were statistically significant differences between the groups in terms of E-index ( p <0.01). Conclusions: When reactive jugular lymph nodes, perithyroidal lymph nodes of Hashimoto thyroiditis patients and parathyroid lesions are compared, it seems that strain sonoelastography indices add a benefit to routine practice in the differential diagnosis of parathyroid lesions and benign neck lymph nodes.

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Intranodal Palisaded Myofibroblastoma: Radiological and Cytological Overview

Cited by 9 publications

References 29 publications

İntranodal Palisad Myofibroblastoma: Klinisyenler ve Patologlar için Histopatolojik ve Klinik İnceleme

İntranodal Palisad Myofibroblastoma: Klinisyenler ve Patologlar için Histopatolojik ve Klinik İnceleme

Intranodal Palisaded Myofibroblastoma: A Diagnostic Differential for Inguinal Lymphadenopathy

Sonoelastographic evaluation for benign neck lymph nodes and parathyroid lesions

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