Massive lung inflammatory myofibroblastic tumor: a case report and literature review_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LONG Yuan ,  PAN Pinhua ,  LI Yuanyuan , HU Chengping , LI Hui

Department of Respiratory and Critical Care Medicine, National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P. R. China;

Corresponding author：

PAN Pinhua, Email: pinhuapan668@126.com; LI Yuanyuan, Email: leeround@163.com

Keywords：

Lung; Massive; Inflammatory myofibroblastic tumor; Inflammatory pseudotumor

DOI：

10.7507/1671-6205.201806054

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Objective To improve the diagnosis and treatment of the disease, the clinical symptoms, pathological features, diagnosis and differential diagnosis, treatment and prognosis of massive lung inflammatory myofibroblastic tumor (IMT) were analyzed.Methods A case, admitted to the Department of Respiratory and Critical Care Medicine of Xiangya Hospital, Central South University, diagnosed as massive lung IMT, was retrospectively analyzed. His clinical and chest radiological data were collected and literature which searched through CNKI, WanFang Med online and PubMed on this subject were reviewed.Results The patient, middle-age male, was presented with cough, dyspnea and weight loss, whose chest radiology was characterized by a large thoracic cavity occupation. He was confirmed with massive lung IMT by several lung biopsy. From above databases, 8 cases were retrieved, including 6 articles in English and 2 articles in Chinese. In 9 cases of massive lung IMT, there were 4 males and 5 females. The age was from 1.5 to 75 years old and the average age was 28 years old. The clinical symptoms were non-specific, and chest imaging was characterized by a large thoracic occupation. One case had distant metastases with bone, adrenal gland and lymph node, and one case had distant metastasis with brain after complete surgery.Conclusions Lung massive IMT has no characteristic clinical and radiological features. And a definite diagnosis depends on pathological biopsy and immunohistochemical analysis. It needs to be differentiated from other thoracic giant tumors. The preferred treatment is complete surgical resection. The prognosis after complete resection is usually good, and probably affected by size.

Citation： LONG Yuan, PAN Pinhua, LI Yuanyuan, HU Chengping, LI Hui. Massive lung inflammatory myofibroblastic tumor: a case report and literature review. Chinese Journal of Respiratory and Critical Care Medicine, 2019, 18(3): 254-258. doi: 10.7507/1671-6205.201806054 Copy

1.	Coffin CM. Inflammatory myofibroblastic tumour: World Health Organization classification of tumours. In: Fletcher CDM, Mertens F. ed. World Health Organization Classification of Tumours Pathology and Genetics of Tumours of Soft Tissue and Bone. Lyon: IARC Press, 2002.
2.	Khatri A, Agrawal A, Sikachi RR, et al. Inflammatory myofibroblastic tumor of the lung. Adv Respir Med, 2018, 86(1): 27-35.
3.	Furukawa N, Hansky B, Niedermeyer J, et al. A silent gigantic solitary fibrous tumor of the pleura: Case report. J Cardiothorac Surg, 2011, 29(6): 122-125.
4.	Pinedo-Onofre JA, Robles-Pérez E, Peňa-Mirabal ES, et al. Giant solitary fibrous tumor of the pleura. Cir Cir, 2010, 78(1): 31-43.
5.	周栋, 邹良建, 金海, 等. 巨大肺炎症性肌纤维母细胞瘤并食管侵犯 1 例. 中华胸心血管外科杂志, 2006, 22(6): 425.
6.	Suetsugu S, Yamamoto H, Izumi M, et al. A case of rapidly growing inflammatory myofibroblastic tumor in the lung. Nihon Kokyuki Gakkai Zasshi, 2009, 47(12): 1156-1160.
7.	Kim KN, Kim DW. Complete resection of a huge hypervascular inflammatory myofibroblastic tumor in right hemithorax after embolization. World J Pediatr, 2016, 12(4): 498-500.
8.	赵树鹏, 齐凤杰, 杨立, 等. 肺巨大炎性肌纤维母细胞瘤伴发脑转移 1 例临床病理分析. 肿瘤防治研究, 2010, 37(5): 609-610.
9.	Okiror L, Draaisma WA, Chinake C, et al. Large pulmonary inflammatory myofibroblastic tumour requiring extrapleural pneumonectomy and diaphragm resection. Gen Thorac Cardiovasc Surg, 2013, 61(3): 163-165.
10.	Prasad MV, Thankachen R, Parihar B, et al. Inflammatory pseudotumour of the lung. Interact Cardiovasc Thorac Surg, 2004, 3(2): 323-325.
11.	Prabhu SM, Choudhury SR, Solanki RS, et al. Multifocal intrathoracic inflammatory myofibroblastic tumour in children. Jpn J Radiol, 2012, 30(5): 453-457.
12.	Tunçözgür B, Ustünsoy H, Bakir K, et al. Inflammatory pseudotumor of the lung. Thorac Cardiov Surg, 2000, 48(2): 112-113.
13.	Brunn H. Two interesting benign lung tumors of contradictory histopathology. J Thorac Surg, 1939, 9: 119-131.
14.	Umiker WO, Iverson L. Postinflammatory tumors of the lung; report of four cases simulating xanthoma, fibroma, or plasma cell tumor. J Thorac Surg, 1954, 28(1): 55-63.
15.	Gleason BC, Hornick JL. Inflammatory myofibroblastic tumours: where are we now?. J Clin Pathol, 2008, 61(4): 428-437.
16.	Surabhi VR, Chua S, Patel RP, et al. Inflammatory myofibroblastic tumors: current update. Radiol Clin North Am, 2016, 54(3): 553-563.
17.	Cerfolio RJ, Allen MS, Nascimento AG, et al. Inflammatory pseudotumors of the lung. Ann Thorac Surg, 1999, 67(4): 933-936.
18.	Cessna MH, Zhou H, Sanger WG, et al. Expression of ALK1 and p80 in inflammatory myofibroblastic tumor and its mesenchymal mimics: a study of 135 cases. Mod Pathol, 2002, 15(9): 931-938.
19.	Montgomery EA, Shuste DD, Burkart AL, et al. Inflammatory myofibroblastic tumors of the urinary tract: a clinicopathologic study of 46 cases, including a malignant example inflammatory fibrosarcoma and a subset associated with high-grade urothelial carcinoma. Am J Surg Pathol, 2006, 30(12): 1502-1512.
20.	Melloni G, Carretta A, Ciriaco P, et al. Inflammatory pseudotumor of the lung in adults. Ann Thorac Surg, 2005, 79(2): 426-432.
21.	Kovach SJ, Fischer AC, Katzman PJ, et al. Inflammatory myofibroblastic tumors. J Surg Oncol, 2006, 94(5): 385-391.
22.	Lovly CM, Gupta A, Lipson D, et al. Inflammatory myofibroblastic tumors harbor multiple potentially actionable kinase fusions. Cancer Discov, 2014, 4(8): 889-895.
23.	Fabre D, Fadel E, Singhal S, et al. Complete resection of pulmonary inflammatory pseudotumors has excellent long-term prognosis. J Thorac Cardiovasc Surg, 2009, 137(2): 435-440.
24.	Andrade FM, Abou-Mourad OM, Judice LF, et al. Endotracheal inflammatory pseudotumor: the role of interventional bronchoscopy. Ann Thorac Surg, 2010, 90(3): e36-e37.
25.	Berardi RS, Lee SS, Chen HP, et al. Inflammatory pseudotumors of the lung. Surg Gynecol Obstet, 1983, 156(1): 89-96.
26.	Mandelbaum I, Brashear RE, Hull MT, et al. Surgical treatment and course of pulmonary pseudotumor (plasma cell granuloma). J Thorac Cardiovasc Surg, 1981, 82(1): 77-82.

1. Coffin CM. Inflammatory myofibroblastic tumour: World Health Organization classification of tumours. In: Fletcher CDM, Mertens F. ed. World Health Organization Classification of Tumours Pathology and Genetics of Tumours of Soft Tissue and Bone. Lyon: IARC Press, 2002.
2. Khatri A, Agrawal A, Sikachi RR, et al. Inflammatory myofibroblastic tumor of the lung. Adv Respir Med, 2018, 86(1): 27-35.
3. Furukawa N, Hansky B, Niedermeyer J, et al. A silent gigantic solitary fibrous tumor of the pleura: Case report. J Cardiothorac Surg, 2011, 29(6): 122-125.
4. Pinedo-Onofre JA, Robles-Pérez E, Peňa-Mirabal ES, et al. Giant solitary fibrous tumor of the pleura. Cir Cir, 2010, 78(1): 31-43.
5. 周栋, 邹良建, 金海, 等. 巨大肺炎症性肌纤维母细胞瘤并食管侵犯 1 例. 中华胸心血管外科杂志, 2006, 22(6): 425.
6. Suetsugu S, Yamamoto H, Izumi M, et al. A case of rapidly growing inflammatory myofibroblastic tumor in the lung. Nihon Kokyuki Gakkai Zasshi, 2009, 47(12): 1156-1160.
7. Kim KN, Kim DW. Complete resection of a huge hypervascular inflammatory myofibroblastic tumor in right hemithorax after embolization. World J Pediatr, 2016, 12(4): 498-500.
8. 赵树鹏, 齐凤杰, 杨立, 等. 肺巨大炎性肌纤维母细胞瘤伴发脑转移 1 例临床病理分析. 肿瘤防治研究, 2010, 37(5): 609-610.
9. Okiror L, Draaisma WA, Chinake C, et al. Large pulmonary inflammatory myofibroblastic tumour requiring extrapleural pneumonectomy and diaphragm resection. Gen Thorac Cardiovasc Surg, 2013, 61(3): 163-165.
10. Prasad MV, Thankachen R, Parihar B, et al. Inflammatory pseudotumour of the lung. Interact Cardiovasc Thorac Surg, 2004, 3(2): 323-325.
11. Prabhu SM, Choudhury SR, Solanki RS, et al. Multifocal intrathoracic inflammatory myofibroblastic tumour in children. Jpn J Radiol, 2012, 30(5): 453-457.
12. Tunçözgür B, Ustünsoy H, Bakir K, et al. Inflammatory pseudotumor of the lung. Thorac Cardiov Surg, 2000, 48(2): 112-113.
13. Brunn H. Two interesting benign lung tumors of contradictory histopathology. J Thorac Surg, 1939, 9: 119-131.
14. Umiker WO, Iverson L. Postinflammatory tumors of the lung; report of four cases simulating xanthoma, fibroma, or plasma cell tumor. J Thorac Surg, 1954, 28(1): 55-63.
15. Gleason BC, Hornick JL. Inflammatory myofibroblastic tumours: where are we now?. J Clin Pathol, 2008, 61(4): 428-437.
16. Surabhi VR, Chua S, Patel RP, et al. Inflammatory myofibroblastic tumors: current update. Radiol Clin North Am, 2016, 54(3): 553-563.
17. Cerfolio RJ, Allen MS, Nascimento AG, et al. Inflammatory pseudotumors of the lung. Ann Thorac Surg, 1999, 67(4): 933-936.
18. Cessna MH, Zhou H, Sanger WG, et al. Expression of ALK1 and p80 in inflammatory myofibroblastic tumor and its mesenchymal mimics: a study of 135 cases. Mod Pathol, 2002, 15(9): 931-938.
19. Montgomery EA, Shuste DD, Burkart AL, et al. Inflammatory myofibroblastic tumors of the urinary tract: a clinicopathologic study of 46 cases, including a malignant example inflammatory fibrosarcoma and a subset associated with high-grade urothelial carcinoma. Am J Surg Pathol, 2006, 30(12): 1502-1512.
20. Melloni G, Carretta A, Ciriaco P, et al. Inflammatory pseudotumor of the lung in adults. Ann Thorac Surg, 2005, 79(2): 426-432.
21. Kovach SJ, Fischer AC, Katzman PJ, et al. Inflammatory myofibroblastic tumors. J Surg Oncol, 2006, 94(5): 385-391.
22. Lovly CM, Gupta A, Lipson D, et al. Inflammatory myofibroblastic tumors harbor multiple potentially actionable kinase fusions. Cancer Discov, 2014, 4(8): 889-895.
23. Fabre D, Fadel E, Singhal S, et al. Complete resection of pulmonary inflammatory pseudotumors has excellent long-term prognosis. J Thorac Cardiovasc Surg, 2009, 137(2): 435-440.
24. Andrade FM, Abou-Mourad OM, Judice LF, et al. Endotracheal inflammatory pseudotumor: the role of interventional bronchoscopy. Ann Thorac Surg, 2010, 90(3): e36-e37.
25. Berardi RS, Lee SS, Chen HP, et al. Inflammatory pseudotumors of the lung. Surg Gynecol Obstet, 1983, 156(1): 89-96.
26. Mandelbaum I, Brashear RE, Hull MT, et al. Surgical treatment and course of pulmonary pseudotumor (plasma cell granuloma). J Thorac Cardiovasc Surg, 1981, 82(1): 77-82.

Chinese Journal of Respiratory and Critical Care Medicine

Massive lung inflammatory myofibroblastic tumor: a case report and literature review

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