Inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT): a representative literature review occasioned by a rare IMT of the transverse colon in a 9-year-old child.

Abstract

AIMS AND BACKGROUND:

Inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT) represent different entities. However, it is only in recent years that this has been taken into increasing consideration. Some authors still use both terms synonymously or interchangeably. Inflammatory myofibroblastic tumor is a real neoplasm because of the proliferation of myofibroblastic cells. Inflammatory pseudotumor is a more inflammatory reactive or regenerative entity and shows an overlapping with immunoglobulin G4-related disease.

METHODS AND STUDY DESIGN:

To analyze the current situation, 443 publications from the last 5 years (2009 to February 2014) were included. Reports involved 938 patients and 956 organ sites. The age distribution is twin peaked with one maximum in childhood and the other between 50 and 60 years of age. This distribution is questionable due to the more frequent occurrence of IPT in the liver and of IMT in the lung. Inflammatory pseudotumors mainly occur in older patients; IMTs in children and young adults.

RESULTS AND CONCLUSIONS:

The liver and biliary tract were the most commonly affected of all body regions, at 32%. This was followed by the lung, including the respiratory tract, at 27%, and by the gastrointestinal tract, at 10%. Lesions of the large bowel, as in the present case of a 9-year-old boy, are very rare. There were organ-related as well as nonspecific clinical symptoms, such as fever, weight loss, and fatigue. Laboratory test results revealed anemia and elevated inflammation-dependent parameters. The patterns in medical imaging are variable and nonspecific. Morphology often suggests a malignant process. For this reason, therapy in most cases is surgical, but this is required more often in IMTs. Many IPTs could be treated conservatively.

• Authors: Sven Höhne, Monika Milzsch, Johannes Adams, Christian Kunze, Rainer Finke
• Journal: Tumori (Tumori) Vol. 101 Issue 3 Pg. 249-56 ( 2015) ISSN: 2038-2529 [Electronic] United States
• PMID: 25983099 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Biomarkers, Tumor
• Anaplastic Lymphoma Kinase
• Receptor Protein-Tyrosine Kinases

Topics

• Adult
• Age Distribution
• Anaplastic Lymphoma Kinase
• Biomarkers, Tumor (analysis)
• Child
• Colonic Neoplasms (chemistry, diagnosis, surgery)
• Granuloma, Plasma Cell (diagnosis, epidemiology, surgery)
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Myofibroblasts (pathology)
• Myofibroma (diagnosis, epidemiology, surgery)
• Plasma Cell Granuloma, Pulmonary (diagnosis)
• Receptor Protein-Tyrosine Kinases (analysis)