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Mediastinum

Other benign / low grade tumors

Inflammatory myofibroblastic tumor


Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 2 March 2013, last major update December 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

See also Soft tissue chapter

General
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● May present with superior vena cava syndrome or cardiorespiratory compromise
● Any age

Terminology
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● Also called inflammatory pseudotumor

Case reports
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● 22 year old woman with calcifying fibrous pseudotumours and multiple pleural and mediastinal lesions (Interact Cardiovasc Thorac Surg 2010;10:652)
● 58 year old woman with mediastinal mass invading sternum, pericardium and pleura (Ann Thorac Surg 2008;86:1362)
● 59 year old man with ALK abnormalities (Virchows Arch 2005;446:451)
● 72 year old man with spontaneous regression of IMT in cardiophrenic angle (Diagn Interv Radiol 2008;14:197)
● Treatment with salvage irradiation and monitoring with FDG-PET/CT (Tumori 2010;96:322)

Xray description
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● Asymmetric mediastinal widening with projection of mass into upper lung field

Gross description
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● Dense white fibrosis, well demarcated from surrounding tissue

Micro description
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● Bland fusiform cells, haphazard or fascicular, with lymphocytes and other inflammatory cells

Micro images
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Recurrent tumor

Positive stains
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● Alpha smooth muscle actin, vimentin

Differential diagnosis
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Sclerosing mediastinitis: see Ann Thorac Surg 2009;88:293

End of Mediastinum > Other benign / low grade tumors > Inflammatory myofibroblastic tumor


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