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Uterus (excludes Cervix)

Stromal tumors

Inflammatory pseudotumor


Reviewer: Mohamed Mokhtar Desouki, MD, PhD (see Reviewers page)
Revised: 15 March 2012, last major update August 2011
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.

Definition
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● The term "inflammatory pseudotumor" is applied to a variety of neoplastic and non-neoplastic entities, characterized by a collection of lymphocytes, plasma cells and neutrophils forming a well circubscribed mass
● Also includes inflammatory myoblastic tumors with distinct clinical, pathological and molecular features

Terminology
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● Inflammatory pseudotumor (IPT), inflammatory myoblastic tumor (IMT)

Epidemiology
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● Younger age than other uterine tumors

Sites
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● All locations

Etiology
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● May be preceded by an acute infection and represent an immunologic reparative response or a low-grade spindle cell fibrosarcoma

Clinical features
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● May present with unexplained fever, abdominal pain, anorexia and weight loss
● On pelvic examination, the uterus may be bulky and tender with restricted mobility giving the impression of "frozen pelvis"
● Laboratory findings: elevated ESR and serum immunoglobulins, thrombocytosis and anemia

Prognostic factors
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● IPTs may recur locally but do not metastasize
● IMTs have intermediate biological potential for local recurrence and distant metastasis
● Mortality rate of 7%

Treatment
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● Surgical excision is curative in 90% of cases
● Antibiotic therapy may be useful

Gross description
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● Circumscribed mass

Micro description
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● Mixture of spindle cells exhibiting storiform pattern together with numerous lymphocytes, plasma cells and histiocytes
● In part, a diagnosis of exclusion

Cytology description
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● Fine needle aspiration may demonstrate inflammatory epitheloid granuloma

Positive stains
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● Vimentin and IL-6

Negative stains
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● Desmin, alpha smooth muscle actin, CD68, lysozyme

Differential Diagnosis
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● Genital tuberculosis
● Inflammatory sarcomatoid carcinomas
● Endometrial stromal sarcoma
● Cellular or inflammatory leiomyoma
● Myometritis

Additional references
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Eur J Obstet Gynecol Reprod Biol 2011;156:118

End of Uterus > Stromal tumors > Inflammatory pseudotumor


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