Fine Needle Aspiration Cytology of Inflammatory Myofibroblastic Tumor of Lung -A Case Report-

폐에 발생한 염증성 근섬유모세포종양의 세침흡인 세포소견 -1예 보고-

  • Park, Gyeong-Sin (Department of Hospital Pathology, College of Medicine, The Catholic University of Korea) ;
  • Lee, Kyung-Ji (Department of Hospital Pathology, College of Medicine, The Catholic University of Korea) ;
  • Lee, Sun-Mi (Department of Hospital Pathology, College of Medicine, The Catholic University of Korea) ;
  • Lee, Kyo-Young (Department of Hospital Pathology, College of Medicine, The Catholic University of Korea) ;
  • Shim, Sang-In (Department of Hospital Pathology, College of Medicine, The Catholic University of Korea) ;
  • Kang, Chang-Suk (Department of Hospital Pathology, College of Medicine, The Catholic University of Korea) ;
  • Lee, Youn-Soo (Department of Hospital Pathology, College of Medicine, The Catholic University of Korea)
  • 박경신 (가톨릭대학교 의과대학 병원병리학교실) ;
  • 이경지 (가톨릭대학교 의과대학 병원병리학교실) ;
  • 이선미 (가톨릭대학교 의과대학 병원병리학교실) ;
  • 이교영 (가톨릭대학교 의과대학 병원병리학교실) ;
  • 심상인 (가톨릭대학교 의과대학 병원병리학교실) ;
  • 강창석 (가톨릭대학교 의과대학 병원병리학교실) ;
  • 이연수 (가톨릭대학교 의과대학 병원병리학교실)
  • Published : 2006.03.31

Abstract

Inflammatory myofibroblastic tumor (IMT), normally referred to as inflammatory pseudotumor, is a fairly rare condition. Fine needle aspiration cytology (FNAC) of IMT has only rarely been reported. Here, we describe one such case of pulmonary inflammatory myofibroblastic tumor. A 30-year-old man presented with a 2.8cm-sized mass in his lung. Chest CT revealed a well defined, poorly enhancing mass. FNAC showed some fascicular or swirled clusters of spindle cells, admixed with occasional inflammatory cells and foamy histiocytes. The majority of the tumor cells evidenced bland, elongated nuclei, but infrequent pleomorphic nuclei. Some of the tumor cells evidenced nuclear grooves and intranuclear inclusions. Although the cytological differentiation of IMT from malignant lesions is not immensely problematic, due to the general paucity of cytological and nuclear atypia, a definite cytological diagnosis of IMT cannot be rendered simply by FNAC. Therefore, a diagnosis of IMT may be suggested via exclusive diagnosis.

Keywords

References

  1. Cerfolio RJ, Allen MS, Nascimento AG, et al. Inflammatory pseudotumors of the lung. Ann Thorac Surg 1999;67:933-6 https://doi.org/10.1016/S0003-4975(99)00155-1
  2. Perrone T, De Wolf Peeters C, Frizzera G. Inflammatory pseudotumor of lymph nodes. A distinctive pattern of nodal reaction. Am J Surg Pathol 1988;12:351-61 https://doi.org/10.1097/00000478-198805000-00003
  3. Anthony PP, Telesinghe PU. Inflammatory pseudotumour of the liver. J Clin Pathol 1986;39:761-8 https://doi.org/10.1136/jcp.39.7.761
  4. Park SY, Gong GY, Huh JR, Yu ES, Lee IC, Kim OJ. Fine needle aspiration cytologic findings of inflammatory pseudotumor of the lymph node. Korean J Cytopathol 1997;8:87-92
  5. Kim YS, Hong EK, Park MH. Fine needle aspiration cytology of inflammatory pseudotumor of the lung. Korean J Cytopathol 1999;10:145-9
  6. Ishida T, Oka T, Nishino T, Tateishi M, Mitsudomi T, Sugimachi K. Inflammatory pseudotumor of the lung in adults: radiographic and clinicopathological analysis. Ann Thorac Surg 1989;48:90-5 https://doi.org/10.1016/0003-4975(89)90187-2
  7. Gal AA, Koss MN, McCarthy WF, Hochholzer L. Prognostic factors in pulmonary fibrohistiocytic lesions. Cancer 1994;73:1817-24 https://doi.org/10.1002/1097-0142(19940401)73:7<1817::AID-CNCR2820730708>3.0.CO;2-K
  8. Bakhos R, Wojcik EM, Olson MC. Transthoracic fine-needle aspiration cytology of inflammatory pseudotumor, fibrohistiocytic type: a case report with immunohistochemical studies. Diagn Cytopathol 1998;19:216-20 https://doi.org/10.1002/(SICI)1097-0339(199809)19:3<216::AID-DC13>3.0.CO;2-H
  9. Thunnissen FB, Arends JW, Buchholtz RT, ten Velde G. Fine needle aspiration cytology of inflammatory pseudotumor of the lung (plasma cell granuloma). Report of four cases. Acta Cytol 1989;33:917-21
  10. Hosler GA, Steinberg DM, Sheth S, Hamper UM, Erozan YS, Ali SZ. Inflammatory pseudotumor: a diagnostic dilemma in cytopathology. Diagn Cytopathol 2004;31:267-70 https://doi.org/10.1002/dc.20113
  11. Wojcik EM, Sneige N, Lawrence DD, Ordonez NG. Fine-needle aspiration cytology of sclerosing hemangioma of the lung: case report with immunohistochemical study. Diagn Cytopathol 1993;9:304-9 https://doi.org/10.1002/dc.2840090312
  12. Barbas CS, Capelozzi VL, Takagaki TY, de Carvalho CR, Barbas Filho JV. Primary malignant fibrous histiocytoma of the lung. Report of a case with bronchial brushing cytologic features. Acta Cytol 1997;41:919-23 https://doi.org/10.1159/000332729
  13. Ali SZ, Hoon V, Hoda S, Heelan R, Zakowski MF. Solitary fibrous tumor. A cytologic histologic study with clinical, radiologic, and immunohistochemical correlations. Cancer 1997;81:116-21 https://doi.org/10.1002/(SICI)1097-0142(19970425)81:2<116::AID-CNCR5>3.0.CO;2-Q
  14. Makhlouf HR, Sobin LH. Inflammatory myofibroblastic tumors (inflammatory pseudotumors) of the gastrointestinal tract: how closely are they related to inflammatory fibroid polyps? Hum Pathol 2002;33:307-15 https://doi.org/10.1053/hupa.2002.32213