Purpose
Inflammatory myofibroblastic tumor of the liver was first described in 1953 by Pack and Baker.
Different synonyms have been used in het literature; Inflammatory pseudotumor,
fibroxanthoma,
Xanthogranuloma type pseudotumor,
Plasma cell granuloma,
Pseudolymphoma,
Histiocytoma and " Plasmacytoma".
Currently,
the most used name is inflammatory pseudotumor.
Inflammatory myofibroblastic tumor is a localized mass consisting of a fibrous stroma and chronic inflammatory infiltrates with a predominance of plasma cells or histiocytes and an absence of anaplasia.
Up to now there has been only few case reports publishing...
Methods and Materials
Thirty three patients (18 male,
15 female,
mean age 51 years) with histopathology proven IMT and CC from 1995- 2011 were included in the study population.
CT-scan was performed in 29 patients and MRI in 20 patients.
All examinations were read independently bytwo radiologists.
The clinical finding,
lesion density/ signal intensity (SI),
dynamic contrast-enhanced characteristics and morphologic charcateristics (size,
margin,
bile duct compression and dilatation,
tumor extension in bile ducts and vascular structure,
liver capsule retraction,
extrahepatic extension and enlarged lymph node)of all lesions wereanalysed...
Results
IMT was proven in 14 (42%) patients and CC in 19 patients (57%).
Clinical finding:
IMT patients often present with fever (n=5,
35%),abdominal pain (n=6,
42%) and blood tests showed often elevated infection parameters ( 57%).
Patients with CC often present with painless jaundice (n=9,
47%) and with elevated liver enzyme in the bloodtests ( 79%).
On imaging,
there is no obvious difference in lesion density or SI between IMT and CC.
Both entities show increasing enhancement during delayed phase.
Morphologic characteristics
IMT
CC
Multifocal...
Conclusion
Differentiating IMT from CC is a challenging clinically and on imaging
No obvious difference in contrast enhancement characteristics (IMT/CC)
Morphological imaging characteristics are important in differentiating IMT from CC
References
Lakshmana Das narla,
et al.
Inflammatory pseudotumor.
Radiographics 2003; 23: 719-929
Liang Tang et al,
Inflammatory myofibroblastic tumor of the liver: A cohort study.
World J.
Surg 2010; 34: 309-313
Gleason B.C,
et al.
Inflammatory myofibroblastic tumours: where are we now.
J Clin Pathol 2008; 61:428-437
Personal Information
R.
Elias1,
F. Willemssen1,
K. Biermann2,
G.
P. Krestin1,
R. Dwarkasing1
1.
Department of Radiology
2.
Department of Pathology
Erasmus MC - University Medical Center
PO Box 2040
3000 CA Rotterdam
The Netherlands
E-mail:
[email protected]