Clinical characteristics, diagnosis and treatment of thoracic inflammatory myofibroblastic tumor_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

JIN Linling ¹ , ZHU Yan ² , JIN Yu ¹ , YAO Xin ¹ , WANG Jiwang ¹ ,  SONG Wei ¹

1. Department of Respiratory and Critical Care Medicine, Jiangsu Province Hospital (The First Affiliated Hospital of Nanjing Medical University), Nanjing, Jiangsu 210029, P. R. China;
2. Department of Pathology, Jiangsu Province Hospital (The First Affiliated Hospital of Nanjing Medical University), Nanjing, Jiangsu 210029, P. R. China;

Corresponding author：

SONG Wei, Email: 45655946@qq.com

Keywords：

Inflammatory myofibroblastic tumor; Thoracic neoplasms; Immunohistochemistry; Surgery

DOI：

10.7507/1671-6205.201910067

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Objective To explore the clinical characteristics, diagnosis and treatment of thoracic inflammatory myofibroblastic tumor.Methods The clinical data, pathological features, treatment and prognosis from 10 patients with thoracic inflammatory myofibroblastic tumor confirmed by pathology were analysed retrospectively from April 2012 to April 2019 at Jiangsu Province Hospital (The First Affiliated Hospital of Nanjing Medical University).Results Ten participants including six males and four females with a mean age of 37.9 years old. Lesions were detected by physical examination in five patients, cough, chest pain and hemoptysis were the common symptoms. A total of 10 lesions including six in the right lung, three in the left lung and one in the mediastinum. Nine patients were treated with surgery, and one patient received high-frequency electrocautery though rigid bronchoscopy under general anesthesia. All the patients were confirmed by immunohistochemistry, positive rate of smooth muscle actin was 70%, positive rate of anaplastic lymphoma kinase was 70%. The mean follow-up time was 35.9 months, and one patient relapsed the other nine patients were cured.Conclusions Inflammatory myofibroblastic tumor is potentially malignant or low malignant, the clinical manifestations and imaging findings are not specific, once confirmed by pathology, radical surgery is the first choice. For the lesion limited to the airway, interventional therapy could be the choice, but close follow up is needed.

Citation： JIN Linling, ZHU Yan, JIN Yu, YAO Xin, WANG Jiwang, SONG Wei. Clinical characteristics, diagnosis and treatment of thoracic inflammatory myofibroblastic tumor. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(6): 563-567. doi: 10.7507/1671-6205.201910067 Copy

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2.	Oztuna F, Pehlivanlar M, Abul Y, et al. Adult inflammatory myofibroblastic tumor of the rachea: case report and literature review. Respir Care, 2013, 58(7): e72-e76.
3.	Reddy S, Swamy R, Irugu DVK, et al. Transtracheal endoscopic-assisted resection of a rare inflammatory myofibroblastic tumour in adult trachea: a case report. Acta Otorhinolaryngol Ital, 2018, 38(2): 170-173.
4.	Pecoraro Y, Diso D, Anile M, et al. Primary inflammatory myofibroblastic tumor of the trachea. Respirol Case Rep, 2014, 2(4): 147-149.
5.	Wang S, Chen L, Cao Z, et al. Inflammatory myofibroblastic tumor of the lumbar spinal canal: a case report with literature review. Medicine (Baltimore), 2017, 96(26): e6488.
6.	Gleason BC, Hornick JL. Inflammatory myofibroblastic tumours: where are we now?. J Clin Pathol, 2008, 61(4): 428-437.
7.	张秀芸. 肺部炎性肌纤维母细胞 16 例患者的 CT 表现及病理分析. 中国 CT 和 MRI 杂志, 2017, 15(9): 67-69.
8.	Özgül MA, Toru Ü, Acat M, et al. A rare tumor of trachea: inflammatory myofibroblastic tumor diagnosis and endoscopic treatment. Respir Med Case Rep, 2014, 13: 57-60.
9.	Shukla PS, Mittal K. Inflammatory myofibroblastic tumor in female genital tract. Arch Pathol Lab Med, 2019, 143(1): 122-129.
10.	吴圣明, 陈军, 李春君, 等. 11 例炎性肌纤维母细胞瘤的临床病理分析. 中国肿瘤临床, 2017, 44(15): 760-763.
11.	刘欣, 张晓伟, 王惠杰, 等. 11 例成人炎性肌纤维母细胞瘤的临床特征分析. 中国癌症杂志, 2018, 28(6): 424-428.
12.	Cerier E, Beal EW, Dillhoff ME. Inflammatory myofibroblastic tumour: an unusual presentation including small bowel obstruction and palpable abdominal mass. BMJ Case Rep, 2018, 2018: bcr2018224549.
13.	Mossé YP, Voss SD, Lim MS, et al. Targeting ALK with crizotinib in pediatric anaplastic large cell lymphoma and inflammatory myofibroblastic tumor: a children’s oncology group study. J Clin Oncol, 2017, 35(28): 3215-3221.
14.	Watanabe H, Uruma T, Tazaki G, et al. Remission of ALK-negative primary pulmonary inflammatory myofibroblastic tumor on treatment with clarithromycin: a case report and review of the literature. Oncol Lett, 2016, 11(3): 1757-1761.

1. Yamamoto H. the WHO classification of tumours editorial board. Fibroblastic/myofibroblastic tumors. WHO classification of tumors of soft tissue and bone, 5th edn. Lyon: international agency for research on cancer, 2020, 109–112.
2. Oztuna F, Pehlivanlar M, Abul Y, et al. Adult inflammatory myofibroblastic tumor of the rachea: case report and literature review. Respir Care, 2013, 58(7): e72-e76.
3. Reddy S, Swamy R, Irugu DVK, et al. Transtracheal endoscopic-assisted resection of a rare inflammatory myofibroblastic tumour in adult trachea: a case report. Acta Otorhinolaryngol Ital, 2018, 38(2): 170-173.
4. Pecoraro Y, Diso D, Anile M, et al. Primary inflammatory myofibroblastic tumor of the trachea. Respirol Case Rep, 2014, 2(4): 147-149.
5. Wang S, Chen L, Cao Z, et al. Inflammatory myofibroblastic tumor of the lumbar spinal canal: a case report with literature review. Medicine (Baltimore), 2017, 96(26): e6488.
6. Gleason BC, Hornick JL. Inflammatory myofibroblastic tumours: where are we now?. J Clin Pathol, 2008, 61(4): 428-437.
7. 张秀芸. 肺部炎性肌纤维母细胞 16 例患者的 CT 表现及病理分析. 中国 CT 和 MRI 杂志, 2017, 15(9): 67-69.
8. Özgül MA, Toru Ü, Acat M, et al. A rare tumor of trachea: inflammatory myofibroblastic tumor diagnosis and endoscopic treatment. Respir Med Case Rep, 2014, 13: 57-60.
9. Shukla PS, Mittal K. Inflammatory myofibroblastic tumor in female genital tract. Arch Pathol Lab Med, 2019, 143(1): 122-129.
10. 吴圣明, 陈军, 李春君, 等. 11 例炎性肌纤维母细胞瘤的临床病理分析. 中国肿瘤临床, 2017, 44(15): 760-763.
11. 刘欣, 张晓伟, 王惠杰, 等. 11 例成人炎性肌纤维母细胞瘤的临床特征分析. 中国癌症杂志, 2018, 28(6): 424-428.
12. Cerier E, Beal EW, Dillhoff ME. Inflammatory myofibroblastic tumour: an unusual presentation including small bowel obstruction and palpable abdominal mass. BMJ Case Rep, 2018, 2018: bcr2018224549.
13. Mossé YP, Voss SD, Lim MS, et al. Targeting ALK with crizotinib in pediatric anaplastic large cell lymphoma and inflammatory myofibroblastic tumor: a children’s oncology group study. J Clin Oncol, 2017, 35(28): 3215-3221.
14. Watanabe H, Uruma T, Tazaki G, et al. Remission of ALK-negative primary pulmonary inflammatory myofibroblastic tumor on treatment with clarithromycin: a case report and review of the literature. Oncol Lett, 2016, 11(3): 1757-1761.

Chinese Journal of Respiratory and Critical Care Medicine

Clinical characteristics, diagnosis and treatment of thoracic inflammatory myofibroblastic tumor

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