Inflammatory pseudotumor of lung, a case report and review of literature

A 21-year-old woman presented with nausea, vomiting, decrease in appetite, and weight loss of 6 months and right chest pain of 5 days' duration. Earlier diagnostic work-ups had been inconclusive, and she was referred for the evaluation of the bilateral lung lesions as seen on her chest x-ray. Thoracic computed tomography scan showed a 6-cm mass in the right lower lobe, a minimal right pleural effusion, and a peripheral 2-cm cavitary nodule in the inferior lingular segment. Ultrasonography-guided transthoracic cutting needle biopsy of the right-sided mass and following right lower lobectomy both yielded benign specimens pathologically assessed as "inflammatory myofibroblastic tumor." The chest x-ray and thoracic computed tomography scans obtained 1 month following the thoracotomy showed spontaneous and almost complete resolution of the left-sided nodule. In follow-up 1 year after the surgery, no clinical, laboratory, or radiologic recurrence was detected. She is being closely followed as an outpatient.

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Inflammatory Myofibroblastic Tumor Presenting as a Large Mass and a Spontaneously Resolving Nodule in the Lung

Bilaçeroğlu¹,

Gürsoy

Yücel³

et al. 2009

Journal of Bronchology &Amp; Interventional Pulmonology

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Inflammatory Pseudotumor of Mediastinum Treated with Tomotherapy and Monitored with FDG-PET/CT: Case Report and Literature Review

Alongi

Bolognesi

Gajate

et al. 2010

Tumori

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Mediastinal inflammatory pseudotumor is a rare disease with reactive pseudoneo-plastic features and a proven capacity for local invasion. The radiographic appearance of inflammatory pseudotumor is quite non-specific and the definitive diagnosis is based on the histological evaluation of tissue specimens. Resection of the lesion is the treatment of choice. However, nonsurgical treatments such as radiotherapy and steroids have been employed in the setting of incomplete surgical resection, tumor recurrence, and patients being unfit for surgery. The case described here is being reported because of the rare mediastinal location and atypical treatment approach including salvage irradiation and monitoring with FDG-PET/CT. Because of the irregular target volume inside the mediastinum as defined by FDG-PET/CT and the significant pulmonary comorbidity, it was deemed necessary to optimize dose delivery with intensity-modulated radiation therapy (IMRT). A possible gain by means of daily control of patient setup with image-guided radiation therapy was also hypothesized and we used tomotherapy to irradiate the lesion. The first FDG-PET/CT after treatment confirmed further reduction of the metabolic activity followed by stable disease in the mediastinum, with no new occurrence of disease 16, 24 and 30 months after tomotherapy.

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Inflammatory Myofibroblastic Tumor of Lung – Computed Tomographic Features in 20 Patients

Ghimire

Zhu

2012

Nep J Radiology

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Aim: To study the salient characteristic computed tomographic findings of inflammatory myofibroblastic tumor of lung. Materials and methods: We retrospectively reviewed the CT examinations of twenty histopathologically confirmed cases of inflammatory myofibroblastic tumor of lung and analyzed the involvement, predominant location, pattern of presentation, shape, edge, pattern and degree of enhancement and any atypical findings in those cases. Results: Fourteen cases presented as pulmonary nodules among which twelve as solitary while two cases as multiple pulmonary nodules. Six cases presented as masses. The location was in the parenchyma of the lung among all cases except two masses that were predominantly mediastinal and endobronchial respectively. All nodules demonstrated mild enhancement except one nodule showed moderate and another one marked enhancement. Four masses demonstrated mild enhancement whearas one showed moderate and another marked enhancement. Pleural surface abutting was noticed in one nodule and two masses. Stippled calcification was present in one mass while necrosis was noticed in two other cases that presented as mass. Mass were associated with consolidation in one and as cavity in another case. Conclusion: Although diagnosis of inflammatory myofibroblastic tumor of lung cannot be confirmed radiologically, certain features as presence of nodules or masses that enhance mildly in a patient with equivocal clinical and radiological presentation warrants its inclusion in the differential diagnosis.

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Inflammatory pseudotumor of lung, a case report and review of literature

Cited by 3 publications

References 9 publications

Inflammatory Myofibroblastic Tumor Presenting as a Large Mass and a Spontaneously Resolving Nodule in the Lung

Inflammatory Myofibroblastic Tumor Presenting as a Large Mass and a Spontaneously Resolving Nodule in the Lung

Inflammatory Pseudotumor of Mediastinum Treated with Tomotherapy and Monitored with FDG-PET/CT: Case Report and Literature Review

Inflammatory Myofibroblastic Tumor of Lung – Computed Tomographic Features in 20 Patients

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