Home   Chapter Home   Jobs   Conferences   Fellowships   Books

 

 

Advertisement 

 

Breast-nonmalignant

Benign tumors / changes

Inflammatory myofibroblastic tumor

 

Reviewer: Hind Nassar, M.D. in January 2009 (see Authors page)

Revised: 7 October 2012, last major update April 2010

Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.

 

Definition

=========================================================================

● Tumor of myofibroblastic spindle cells and inflammatory cells

 

Terminology

=========================================================================

● Also called inflammatory pseudotumor, plasma cell granuloma

 

Epidemiology

=========================================================================

● Extremely rare in breast with <20 cases reported

 

Sites

=========================================================================

 

Etiology

=========================================================================

● May be part of an IgG4 related sclerosing disease (New Engl J Med 2001;344:732, World J Gastroenterol 2008;14:3948)

 

Clinical features

=========================================================================

 

Prognostic factors

=========================================================================

 

Case reports

=========================================================================

● 46 year old woman with IgG4 related inflammatory pseudotumor (Am J Surg Pathol 2005;29:275)

● 50 year old woman with breast mass (University of Oklahoma)

● 60 year old woman with suspicious mammogram (Korean J Radiol 2009;10:515)

 

Treatment

=========================================================================

 

Clinical images

=========================================================================

 

Gross description (Macroscopy)

=========================================================================

● Firm, circumscribed, yellow

 

Gross images

=========================================================================

 

Micro description (Histopathology)

=========================================================================

● Nodular with fibrovascular stroma containing myofibroblast-like cells and lymphoplasmacytic infiltrate

● May have primarily inflammatory features (diffuse lymphoplasmacytic infiltration and lymphoid follicles), resemble myofibroblastic tumors or be hypocellular (scar-like)

● Often mixed patterns (Am J Clin Path 1988;90:627)

 

Micro images

=========================================================================

 

                                     

Myoblastic spindle cells                                   Various images

and inflammatory cells

 

 

Fig. 1

Various images

 

 

      

H&E and ALK1        CD34+                    p53-

 

 

      

Bladder: spindle cells and inflammatory cells in myxoid stroma

 

Virtual Slides

=========================================================================

 

Videos

=========================================================================

 

Cytology description

=========================================================================

● Inflammatory lesion with occasional aggregates of cellular connective tissue fragments, sheets of uniform ductal epithelial cells with myoepithelial cells, spindle cells, lymphocytes and histiocytelike cells (Acta Cytol 2003;47:1077)

 

Cytology images

=========================================================================

 

Positive stains

=========================================================================

Spindle cells - smooth muscle actin, vimentin, variable keratin

● Plasma cells may be IgG4+

 

Negative stains

=========================================================================

 

Electron microscopy descriptions

=========================================================================

 

Electron microscopy images

=========================================================================

 

Myofibroblastic features of rough endoplasmic reticulum,

peripheral smooth muscle myofilaments and fibronectin fibrils

 

Molecular / cytogenetics description

=========================================================================

● Some cases are clonal (J Pathol 2002;196:97)

 

Molecular / cytogenetics images

=========================================================================

 

Fig A: ALK gene rearrangement 

 

Differential Diagnosis

=========================================================================

Spindle cell carcinoma: sarcoma like features but keratin+ (Ann Diagn Pathol 2005;9:123)

 

Additional references

=========================================================================

 

End of Breast-nonmalignant > Benign tumors / changes > Inflammatory myofibroblastic tumor

 

 

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must also be interpreted in the context of a patient's clinical data using reasonable medical judgment.  This website should not be used as a substitute for the advice of a licensed physician.

 

All information on this website is protected by copyright of PathologyOutlines.com, Inc.  Information from third parties may also be protected by copyright.  Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).