Learning objectives
Review the pathogenesis and molecular biology of inflammatory myofibroblastic tumors (IMT) of the thorax and abdomen.
And discuss the cross-sectional imaging findings of the thoracic and abdominal IMTs.
Background
IMT is an uncommon entity with benign behavior that occurs primarily in children and young adults.
Its pathogenesis is poorly understood and its neoplastic nature is still discussed.
It can be found in almost any part of the body,
being the lung parenchyma the most frequent location,
followed by the abdomen.
The clinical presentation is very variable and depends on its location.
They become patent in the imaging methods as a mass with nonspecific characteristics,
therefore making its diagnosis a real challenge.
Findings and procedure details
The inflammatory myofibroblastic tumor was initially described in the lung by Brunn in 1939,
and designated as an inflammatory pseudotumor in 1954 by Umiker et al.
for its propensity to simulate clinically and radiologically a malignant process [1,
2].
In 2004,
the World Health Organization (WHO) assigns its current name and describes it as a lesion composed of fusiform myofibroblastic cells accompanied by an inflammatory infiltrate [3].
It occurs most frequently in the lung,
but cases have been described in almost any location and system....
Conclusion
The IMT is a rare entity,
with nonspecific clinical and imaging features,
being its diagnose confirmed by surgical pathology.
For these reasons,
the radiologist must consider it among the differential diagnoses when facing a young patient with a chest or abdominal mass without a relevant personal history of malignancies.
References
Narla L,
Newman B,
Spottswood S,
Narla S,
Kolli R.
Inflammatory Pseudotumor.
RadioGraphics.
2003;23(3):719-729.
Gleason B,
Hornick J.
Inflammatory myofibroblastic tumours: where are we now? Journal of Clinical Pathology.
2008;61(4):428-437.
Coffin CM,
Fletcher JA.
Inflammatory myofibroblastic tumor.
In: Fletcher CDM,
Unni KK,
Mertens F,
eds.
World Health Organization classification of tumours.
Pathology and genetics of tumours of soft tissue and bone.
Lyon: IARC Press,
2002:91-93.
Surabhi V,
Chua S,
Patel R,
Takahashi N,
Lalwani N,
Prasad S.
Inflammatory Myofibroblastic Tumors.
Radiologic Clinics of North America....