Inflammatory myofibroblastic tumor (IMT) is an uncommon myofibroblastic neoplasm that was formerly included within the broad category of inflammatory pseudotumor (IPT).IMT is rarely encountered in the liver.Similar to...Inflammatory myofibroblastic tumor (IMT) is an uncommon myofibroblastic neoplasm that was formerly included within the broad category of inflammatory pseudotumor (IPT).IMT is rarely encountered in the liver.Similar to IMT of other organs,the interchangeable use of the terms IMT and IPT in liver has made the analysis of these lesions difficult.In this review,clinical and pathological features of IMT of the liver are reviewed and the differential diagnosis of IMT is discussed,with emphasis on IPT and the other entities included in this large category.IMT can mimic malignant tumors.There are no known unique diagnostic clinical,laboratory,or radiological features.The definitive diagnosis of IMT depends on careful pathological examination.The histopathological evaluation of hepatic IMT reveals that,the myxoid/vascular pattern is the most frequently observed,followed by,in decreasing frequency,fibrous histiocytomalike pattern and hypocellular fibrous pattern.In IMT of the liver,anaplastic lymphoma kinase (ALK) expression reliably predicts the presence of an ALK gene rearrangement.The diagnosis of hepatic IMT depends on the dominant histopathological pattern,and the management of the disease is still controversial.IMTof the liver is a distinctive neoplasm of intermediate biological potential,and should be distinguished from the variety of lesions that are included under the broad category of IPT.Therefore,to avoid confusion regarding the true incidence and behavior of hepatic IMT,the term IPT should not be used interchangeably with IMT.The rarity of IMT in liver should not minimize its consideration in the differential diagnosis of liver tumors,especially in patients with tumor markers in normal range.展开更多
An inflammatory pseudotumor (IPT) is a relatively rare lesion characterized by chronic inf iltration of inflammatory cells and areas of f ibrosis. IPTs are diff icult to diagnose because of the absence of specif ic sy...An inflammatory pseudotumor (IPT) is a relatively rare lesion characterized by chronic inf iltration of inflammatory cells and areas of f ibrosis. IPTs are diff icult to diagnose because of the absence of specif ic symptoms or of characteristic hematological or radiological f indings. In this study, a case of a woman aged over 70 years was reported, who presented with a general malaise lasting more than two months. A computed tomography scan demonstrated a diffusely spread lesion of the liver with a portal vein occlusion and a splenic lesion surrounded by a soft density layer. Since the percutaneous liver biopsy showed f indings that suggested an IPT, although the radiological f indings did not exclude the possibility of a malignancy, we performed a percutaneous spleen biopsy to enable a more defi nitive diagnosis. The microscopic f indings from the spleen specimen lead us to a diagnosis of IPT involving the liver and spleen. Sub-sequent steroid pulse therapy was effective, and rapid resolution of the disease was observed.展开更多
文摘Inflammatory myofibroblastic tumor (IMT) is an uncommon myofibroblastic neoplasm that was formerly included within the broad category of inflammatory pseudotumor (IPT).IMT is rarely encountered in the liver.Similar to IMT of other organs,the interchangeable use of the terms IMT and IPT in liver has made the analysis of these lesions difficult.In this review,clinical and pathological features of IMT of the liver are reviewed and the differential diagnosis of IMT is discussed,with emphasis on IPT and the other entities included in this large category.IMT can mimic malignant tumors.There are no known unique diagnostic clinical,laboratory,or radiological features.The definitive diagnosis of IMT depends on careful pathological examination.The histopathological evaluation of hepatic IMT reveals that,the myxoid/vascular pattern is the most frequently observed,followed by,in decreasing frequency,fibrous histiocytomalike pattern and hypocellular fibrous pattern.In IMT of the liver,anaplastic lymphoma kinase (ALK) expression reliably predicts the presence of an ALK gene rearrangement.The diagnosis of hepatic IMT depends on the dominant histopathological pattern,and the management of the disease is still controversial.IMTof the liver is a distinctive neoplasm of intermediate biological potential,and should be distinguished from the variety of lesions that are included under the broad category of IPT.Therefore,to avoid confusion regarding the true incidence and behavior of hepatic IMT,the term IPT should not be used interchangeably with IMT.The rarity of IMT in liver should not minimize its consideration in the differential diagnosis of liver tumors,especially in patients with tumor markers in normal range.
文摘An inflammatory pseudotumor (IPT) is a relatively rare lesion characterized by chronic inf iltration of inflammatory cells and areas of f ibrosis. IPTs are diff icult to diagnose because of the absence of specif ic symptoms or of characteristic hematological or radiological f indings. In this study, a case of a woman aged over 70 years was reported, who presented with a general malaise lasting more than two months. A computed tomography scan demonstrated a diffusely spread lesion of the liver with a portal vein occlusion and a splenic lesion surrounded by a soft density layer. Since the percutaneous liver biopsy showed f indings that suggested an IPT, although the radiological f indings did not exclude the possibility of a malignancy, we performed a percutaneous spleen biopsy to enable a more defi nitive diagnosis. The microscopic f indings from the spleen specimen lead us to a diagnosis of IPT involving the liver and spleen. Sub-sequent steroid pulse therapy was effective, and rapid resolution of the disease was observed.
