Gastric inflammatory pseudotumor in children.

Maves, Constance; Johnson, J. F.; Bove, K E; Malott, Richelle L.

doi:10.1148/radiology.173.2.2678252

Cited by 75 publications

(46 citation statements)

References 0 publications

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“…This lesion has no sex predilection and may occur at any age. Plasma cell granuloma is thought to result from inflammation following minor trauma or surgery or to be associated with malignancy [13][14][15], however, this was not so in the present case and our patient was free of any history of trauma or malignancy. However his oral hygiene was extremely poor with generalized chronic destructive periodontitis, which could have contributed to the genesis of this lesion, which was present on the gingival and was solitary.…”

Section: Discussioncontrasting

confidence: 65%

Value of Immunohistochemistry in Diagnosing a Rare Case of Maxillofacial Plasma Cell Granuloma Masquerading as a Gingival Epulis

Jeyaraj

Bandyopadhyay

Naresh

et al. 2013

J. Maxillofac. Oral Surg.

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Background Plasma cell granuloma is a non-neoplastic lesion rather uncommonly seen in the maxillofacial region. Its etiology, biological behavior, ideal treatment and prognosis are still unclear and rather controversial. Study A detailed histopathological examination and immunohistochemical study of the excised specimen was carried out, both for making a confirmatory diagnosis as well as to determine the etiopathology, biological behavior and prognosis of the lesion. Results Light microscopy revealed a hyperplastic stratified squamous epithelial lining, overlying a densely fibrocellular granulation tissue containing a rich proliferation of mononuclear inflammatory cells, among which there was a predominance of plasma cells with their typical eccentric, cartwheel shaped, ''clock-faced'' nuclei. Strong immunohistochemical positivity was observed for CD-138 by numerous cells of the connective tissue of the lesion, thus confirming them to indeed be plasma cells. Further, immunohistochemistry (IH) analysis also demonstrated the expression of both, the lambda and kappa light chain immunoglobulins by the plasma cell population, thus confirming them to be polyclonal and of an inflammatory, non-neoplastic origin. Summary and ConclusionAs a plasma cell granuloma is rarely encountered in the oral and maxillofacial region, its diagnosis could have been very easily missed, had it not been for the detection of the large numbers of plasma cells by light microscopy, which was further confirmed by IH. IH also helped in establishing the likely etiopathology of the lesion and confirmed it to be of a non-neoplastic reactive/inflammatory origin.

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Section: Discussioncontrasting

confidence: 65%

Value of Immunohistochemistry in Diagnosing a Rare Case of Maxillofacial Plasma Cell Granuloma Masquerading as a Gingival Epulis

Jeyaraj

Bandyopadhyay

Naresh

et al. 2013

J. Maxillofac. Oral Surg.

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“…5 The etiology of these tumors is not known but they may represent an unusual inflammatory response to precipitating factors such as surgery, trauma and localized infection. 5,6 This is supported by the fact that the spindle cells in the lesion are actually myofibroblast cells that are found in granulation and scar tissue, and hence they may be representative or an unusual variant of the inflammatory response. 7 The sites most frequently reported in the literature to be involved in pseudotumor formation include lung, liver, intestine and stomach.…”

Section: Discussionmentioning

confidence: 96%

Inflammatory Pseudotumor: An Unusual Cause of Fever of Unknown Origin

Alansari

Novelli

1997

Ann Saudi Med

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The accepted definition of a fever of unknown origin (FUO) is a fever of more than 38.5°C, present for more than two weeks in a child in whom a thorough history, physical examination and preliminary laboratory tests have failed to reveal an etiology. 1 The development of new imaging techniques (e.g., MRI scan, Tc-labeled white cell scan) has added to our diagnostic resources in evaluating the cause of a FUO. The three most common discernible categories of FUO in children include infectious diseases, collagen-vascular disorders and neoplasms.2 There is also a group of miscellaneous causes which usually account for about 10%-15% of cases.3 Although FUO in children is more likely to be caused by an unusual presentation of a common disorder rather than an exotic illness, we present a child with a rare cause for a FUO who was cured by a surgical procedure. Case ReportA 10-year-old Caucasian boy was referred for further investigation because of fever, anemia and thrombocytosis, present for five weeks. Four months earlier he had been kicked on the left thigh and subsequently developed a persistent hard lump at the site. A month later he was noted to be very pale and lethargic. He was seen at the local hospital when on physical examination a 3.5 × 3 cm swelling was noted on the medial surface of the left thigh, with an overlying area of bruised skin. A CT scan of the thigh suggested the swelling to be a hematoma and aspiration revealed only red blood cells, all cultures being negative. Laboratory investigations showed a Hb of 7.3 g/dL, and a blood film which was hypochromic and microcytic. He was then transfused, given iron supplements and discharged from hospital.Five weeks prior to referral the patient was readmitted to the local hospital because he was consistently spiking fevers to 39°C, and continued to be pale and lethargic. Physical examination was basically normal apart from the swelling in the left thigh and two small (<1 cm) non-tender lymph nodes in the left groin. Investigations showed the following: Hb 8 g/dL, WBC 10 × 10 9 /L (10,000/mm 3 ) (neutrophils 75%, lymphocytes 19%, monocytes 6%), platelets 898 × 10 9 /L (898,000/mm 3 ). The blood film showed a microcytic, hypochromic picture with hypersegmented neutrophils. The sedimentation rate was 168 mm/hr, with a CRP of 17.4 mg/dL. A chest x-ray was normal; a PPD skin test was negative; repeated blood, urine and stool cultures were also negative. There was no serological evidence of infection due to CMV, EBV, adenovirus, brucellosis, psittacosis, mycoplasma, legionella, toxoplasma or Q fever. A barium meal, CT scan of the abdomen and Tc-bone scan were unremarkable. Rheumatoid factor and ANA were negative. Serum immunoglobulins were within normal limits. An echocardiogram showed a normal heart with no evidence of vegetations. A bone marrow aspirate showed normal cellular particulate with trilineage representation indicating a reactive marrow, suggestive of chronic disease. Iron stores in the bone marrow were normal; cultures were negative.Following these nega...

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“…1 In certain cases, it is thought to result from infl ammation following minor trauma or surgery or is associated with other malignancy. 1,4,6 The ones secondary to infection that are found in association with the organism include mycobacteria associated with spindle cell tumor; Epstein-Barr virus found in splenic and nodal pseudotumors; actinomycetes and nocardiae found in hepatic and pulmonary pseudotumors, respectively; and mycoplasma in pulmonary pseudotumors. 1,7 There have been reports of patients younger than 16 years developing infl ammatory pseudotumors that most frequently present as primary tumor-like lesions of the lung.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, other unusual infl ammatory or immune responses, such as sclerosing cholangitis, phlebitis, and retroperitoneal fi brosis, have been found in association with infl ammatory pseudotumor. 12,13 Spindle cell tumors in the liver have been described in immunocompromised patients after transplantation. Although these tumors occur much less commonly than posttransplantation lymphoproliferative disorder, Epstein-Barr virus has also been implicated in some of these lesions.…”

Section: Discussionmentioning

confidence: 99%