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Clinical and pathologic considerations in a case of inflammatory myofibroblastic tumor of the spleen.

Inflammatory myofibroblastic tumors, also called inflammatory pseudotumors, are rare pseudosarcomatous proliferations. Their behavior is generally not aggressive, but in most instances they can simulate malignant neoplasms, from which they are impossible to distinguish before excision. One case of myofibroblastic tumor of the spleen in a 5-year-old boy is described: the patient was treated with a partial splenectomy, which was found to be the best approach for diagnosis and treatment. The purpose of this report is to call attention to this entity with peculiar histologic and immunohistochemical characteristics, which has to be included in the differential diagnosis of splenic lesions and may be excised by a nonaggressive procedure.

Child, Preschool↗

Post-menopausal vaginal angiomyofibroblastoma: a case report.

Angiomyofibroblastoma (AMF) is a recently described, rare, benign soft tissue vulvovaginal tumour that occurs mainly but not exclusively in the vulval region of pre-menopausal women (Fletcher et al. in Am J Surg Pathl 16:373; 1992). The first case was diagnosed in 1992. We report a case of a post-menopausal woman with a 2-month history of a rapidly growing painless vaginal tumour and thus drawing the attention of gynaecologist as well as general practitioners to the fact that this rare phenomenon can occur outside the vulva.

Female↗

Pancreatic malignant fibrous histiocytoma, inflammatory myofibroblastic tumor, and inflammatory pseudotumor related to autoimmune pancreatitis: characterization and differential diagnosis.

Malignant fibrous histiocytoma (MFH) and inflammatory myofibroblastic tumor (IMT) are uncommon primary non-epithelial cell tumors of the pancreas. In addition, there are inflammatory pseudotumors (IPT) that may arise in the course of autoimmune pancreatitis (AIP). In the English language literature, only 24 cases of IMT and nine cases of MFH in the pancreas have been reported to date. We investigated three individual spindle cell tumors of the pancreas that were identified as MFH, IMT, and IPT, respectively, using immunohistochemical and molecular analysis. Both the MFH and the IMT, but not the IPT, showed nuclear p53 expression and mutations of the p53 gene. The MFH and the IMT also had higher mitotic and Ki-67 (MIB-1) indexes than the IPT. The IPT was found to be a tumor-like case of AIP. Many IgG4-positive plasma cells, which are considered to be a feature of AIP, were found in all three tumors. It is concluded that in this series of spindle cell tumors of the pancreas, apart from immunohistochemical features, the demonstration of p53 mutations may be helpful in distinguishing true neoplastic tumors from pseudotumors such as IPTs arising in the context of AIP.

Adult↗

Congenital granular-cell myoblastoma.

The clinical and pathologic features of congenital granular-cell myoblastoma in five infant girls are reported. One lesion, treated expectantly, progressively decreased in size and after 3 yr and 9 mo could not be detected, while two lesions which were imcompletely excised did not recur. It is suggested that congenital granular-cell myoblastoma is caused by an intrauterine stimulus, and that this stimulus may possible be production of estrogen by the fetus. Congential granular-cell myoblastoma should be treated expectantly or by limited excision, and has an excellent prognosis.

Child, Preschool↗

Pictorial review: magnetic resonance imaging of benign soft tissue masses of the hand and wrist.

Magnetic resonance imaging (MRI) is the imaging method of choice for evaluating the presence and extent of soft tissue masses. It is particularly useful for assessing masses in the wrist and hand, where benign lesions predominate. A specific diagnosis may be made, or strongly suspected, from the characteristic MRI features found in certain conditions like ganglion, haemangioma, arteriovenous malformation, giant cell tumour of the tendon sheath and lipoma.

Arteriovenous Malformations↗

Causes of apparent low levels of misonidazole in human tumours.

Although the concentration of misonidazole measured in human tumours may appear to be only 50--70% of the corresponding blood level, the concentration within the intra- and extracellular fluid of the tumour may be nearer 100% of the blood level. Causes for these apparent low levels of drug which have been investigated are: 1. Presence of fat in the tissue. 2. Presence of non-cellular material in the tissue. 3. Degradation of the drug by anaerobic metabolism after biopsy. An in vitro experiment to test the partitior fractionation study of the distribution of misonidazole showed that it is distributed mainly in the fluid compartment of the cell and that overall drug levels in tissue are related to the fluid content of the tissue. Serial measurements of misonidazole on tissue after removal from the body have shown that breakdown of the drug occurs when the tissue becomes anoxic. These results suggest that the concentration of misonidazole present within tumour cells is higher than the overall level measured for the tissue and that the enhancement ratio to be expected may therefore be higher also.

Adipose Tissue↗

Inflammatory (pseudosarcomatous) myofibroblastic tumor of the urinary bladder causing acute abdominal pain.

Inflammatory myofibroblastic tumor is a reactive proliferation of myofibroblasts that rarely involves the urinary bladder. The cause of inflammatory myofibroblastic tumor is unknown but may represent an initial reactive process to an infectious agent or trauma that transforms into neoplastic growth. Cases reported in children, however, often lack any preexisting bladder pathology. The authors present a case in a young child that presented as acute abdominal pain. In general, these tumors follow a benign clinical course after resection, although close monitoring is essential given the rarity of this bladder lesion.

Abdomen, Acute↗