Salivary glands - Inflammatory myofibroblastic tumor

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Salivary glands

Epithelial / myoepithelial tumors

Inflammatory myofibroblastic tumor

Reviewer: Adriana Handra-Luca, M.D. (see Reviewers page)
Revised: 27 January 2013, last major update September 2012
Copyright: (c) 2003-2013, Pathol2gyOutlines.com, Inc.

General
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● Uncommon salivary gland tumor of myofibroblasts and chronic inflammatory cells; benign behavior at this site
● Some cases are neoplastic
● Also called inflammatory pseudotumor; formerly called plasma cell granuloma
● Usually >50 years, males
● Parotid gland most common salivary gland site

Clinical description
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● Recurrent painful swelling

Case reports
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● 66 year old man with parotid tumor with clonal cytogenetic abnormalities (Acta Otolaryngol 2005;125:433)
● 70 year old man with submandibular gland tumor and autoimmune-like symptoms (Arch Pathol Lab Med 2001;125:1095)

Treatment
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● Surgical resection

Gross description
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● Firm nodules, homogeneous yellow gray

Micro description
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● Myofibroblasts, histiocytes, plasma cells, lymphocytes (Am J Surg Pathol 1992;16:896)

Micro images
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Multinodular tumor with thick fibrous bands, plasma cells and lymphocytes, spindle cells in poorly formed fascicles, smooth muscle actin+

Various images

Cytology description
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● Groups of spindle cells without cytologic atypia, inflammatory cells, foamy histiocytes (Acta Cytol 2004;48:574)

Positive stains
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● Spindle cells: CD68/KP1, smooth muscle actin, muscle specific actin, vimentin

Differential diagnosis
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● MALT lymphoma
● Myoepithelioma
● Sialadenitis

End of Salivary glands > Epithelial / myoepithelial tumors > Inflammatory myofibroblastic tumor

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