Pulmonary Inflammatory Pseudotumor (Inflammatory Myofibroblastic Tumor)

Abstract

The objective of this study was to assess the CT features of pulmonary inflammatory myofibroblastic tumors with pathologic correlation. The authors retrospectively reviewed CT and pathologic findings of 10 patients with surgically resected inflammatory myofibroblastic tumor of the lung. On CT, five patients showed a polypoid endotracheal (n = 3) or endobronchial nodule in the left main bronchus (n = 2). Two patients showed a central parenchymal mass, and the remaining three patients showed a peripheral pulmonary nodule. All tumors had well defined margins and were round to ovoid; they ranged in diameter from 13 to 52 mm and showed varying degrees of contrast enhancement (range 13-89 H). On histopathologic examination, the two central parenchymal masses involving segmental bronchi were also mainly endobronchial in location. The three peripheral pulmonary nodules also showed a peribronchiolar location, with a bronchial mucosal lining spared in part. The authors conclude that pulmonary inflammatory myofibroblastic tumors are closely related to the airway.

A Case of Endobronchial Inflammatory Pseudotumor Invading the Mediastinum

“…The prognosis of patients with completely resected inflammatory pseudotumors is excellent: 78% to 100% of patients were in complete remission after an average follow-up of 3.3 years after surgical resection. Intrathoracic recurrence was seen in 5% of cases (10). The tumor may be fatal.…”

“…When wedge resection is not feasible, the lesion is removed with major resections such as lobectomy or pneumonectomy. Nonsurgical treatment modalities including radiotherapy, chemotherapy, and steroids may have a place in the setting of incomplete surgical resection, multifocal disease, tumor recurrence, or contraindication to lung resection (6,8,10,14). The prognosis of patients with completely resected inflammatory pseudotumors is excellent: 78% to 100% of patients were in complete remission after an average follow-up of 3.3 years after surgical resection.…”

“…Multiple recurrences and metastatic spread can also be seen (6,10,11,13). Corneli et al reported that the tumor invaded the mediastinal pleura, the pericardium, the esophagus, the thoracic aorta and the diaphragm (6).…”

Tracheobronchial mucoid pseudotumor

“…With regard to the endobronchial polypoid lesion, we must rule out diseases such as primary lung cancer [5], endobronchial pseudotumor (inflammatory myofibroblastic tumor) [6,7], thymoma [8,9], fungal infection [10,11], and metastatic endobronchial tumors [12][13][14][15]. In primary lung cancer, endobronchial polypoid lesions are observed in patients with squamous cell carcinoma.…”

“…Polyploidy lesion in tracheobronchus has been observed in some patients with infectious or tumorous diseases [1,2,[5][6][7][8][9][10][11][12][13][14][15][16][17][18]. However, large and long mucoid plug of tracheobronchus simulating a tumor has been rarely reported [1,2].…”