Résumé
Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal soft tissue tumor characterized by borderline or low-grade malignancy. It is rare childhood tumor with an average age of onset of 10 years old. It is even rarer in infants and toddlers, and the etiology and pathogenesis of this tumor are still unclear. The clinical presentation of IMT is non-specific and are related to the location of the tumor. When the tumor compresses adjacent organs, it can cause pain and functional impairment. According to the current literature, IMT is most commonly found in the digestive and respiratory systems, but also occasionally occur in the genitourinary system, head and neck, and limbs. At present, there have been no reports of nasopharyngeal IMT involving nasal cavity of infants and toddlers at home and abroad.This article reports a case of a massive inflammatory myofibroblastic tumor involving the nasal cavity and nasopharynx in an infant. Plasma-assisted minimally invasive surgery was performed through multiple surgical approaches and achieved satisfactory therapeutic results. This case report may provide valuable reference for the treatment of similar diseases.
Sujets)
Humains , Nourrisson , Granulome à plasmocytes/anatomopathologie , Partie nasale du pharynx/anatomopathologie , Tumeurs du tissu musculaire , Tumeurs des tissus mousRésumé
RESUMEN El pseudotumor inflamatorio hepático es una lesión muy infrecuente, sin una etiología ni patogenia claras. Su diagnóstico preoperatorio no es habitual pero, en caso de realizarse, puede evitar la cirugía. Presentamos el caso de un paciente joven, con antecedente de lupus cutáneo que, tras debutar con una pancreatitis aguda, presenta episodios de colangitis y cuyos hallazgos radiológicos no permiten descartar la presencia de un colangiocarcinoma, por lo que se realiza hepatectomía izquierda, siendo el diagnóstico histológico final de pseudotumor inflamatorio hepático.
ABSTRACT Inflammatory pseudotumors of the liver are rare and lack clear etiology and pathogenesis. The preoperative diagnosis is seldom made but it avoids unnecessary surgery. We report the case of a young male patient with a history of cutaneous lupus and episodes cholangitis after an acute pancreatitis. As the imaging tests could not rule out cholangiocarcinoma, a left liver resection was performed, and the final histologic diagnosis was inflammatory pseudotumor of the liver.
Sujets)
Humains , Mâle , Adulte , Granulome à plasmocytes/chirurgie , Maladies du foie , Angiocholite/complications , Cholangiopancréatographie rétrograde endoscopique , Granulome à plasmocytes/anatomopathologie , Granulome à plasmocytes/imagerie diagnostique , HépatectomieRésumé
Inflammatory Myofibroblastic Tumor (IMT) is a rare pathologic entity that was first described in 1973. This lesion is most commonly found in the lungs, but other organs' involvement has also been reported. Intracranial location of Inflammatory Myofibroblastic Tumor is rare, and the first case was reported in 1980. An intriguing fact about the intracranial IMT is its resemblance with meningioma on clinical presentation and neuroimaging. We came across a case of intracranial Inflammatory Myofibroblastic Tumor (IIMT) in a 27-year-old male who presented with recurrent episodes of seizures and was diagnosed as meningioma on neuroimaging. The lesion did not subside with medical management and kept on progressing in size. The patient had to undergo surgery, and diagnosis of Inflammatory Myofibroblastic Tumor was ascertained on histopathology. This 'surprise' diagnosis prompted us to review the literature on all cases of IIMTs reported to date to better understand the entity and its implications. In this review article, we present our observations regarding various studied parameters, including patient profile, clinical presentation, site of involvement, focality of the lesion, special associations, and lines of management of the 49 published cases of IIMTs.
Sujets)
Humains , Mâle , Adulte , Tumeurs du cerveau , Myofibroblastes , Granulome à plasmocytes/anatomopathologie , Crises épileptiques , Maladies rares , Tumeurs des méninges , Méningiome/diagnosticRésumé
Plasma cell granuloma is a rare benign tumor lesion that is classified and described under the pseudo inflammatory tumor category. Its occurrence in the oral cavity is rare, making diagnosis and treatment really difficult, as it bears some clinical similarity with malignant tumor diseases. Proper diagnosis and treatment of PCG requires performing biopsy and a histopathological/immunohistochemicalstudy to rule out possible plasma and neoplastic cell dyscrasias. Consequently, the use of these auxiliary diagnostic devices will enable us to provide the appropriate treatment for the patient. In this study, we present the case of a 63-year-old female patient with a tumor/ulcerative lesion of the left buccal mucosa of a month of evolution and a tumor/ulcerative lesion on the right buccal mucosa of 15 days of evolution after the onset of the first lesion. The patient was treated successfully for a period of one year with immunosuppressive drugs, and to date the disease is inactive. The purpose of this paper is to show one of the most unusual locations in the oral cavity affected by this pathological entity, its clinical and histological features, and establish the differential diagnosis correctly with other malignant or benign disease entities, suggesting the most suitable treatment for this type of condition...
El Granuloma de Células Plasmáticas es una rara lesión tumoral benigna descrita dentro de la clasificación de tumores pseudoinflamatorios, es rara su aparición dentro de la cavidad oral, haciendo realmente complicado su diagnóstico y tratamiento, ya que presenta similitud clínica con patologías tumorales malignas. Para el adecuado diagnóstico y tratamiento del GCP, se requiere de la realización de biopsia y estudio histopatológico/inmunohistoquímico, para descartar posibles discrasias de las células plasmáticas y neoplásicas, de tal forma que el uso de estos auxiliares de diagnóstico nos permitirá sustentar de manera adecuada el tratamiento otorgado al paciente. Se presenta el caso de paciente femenino de 63 años de edad, con una lesión tumoral/ulcerativa de la mucosa yugal izquierda de un mes de evolución y lesión tumoral/ulcerativa de la mucosa yugal derecha de 15 días de evolución posterior a la aparición de la primera lesión, tratada por un periodo de un año con inmunosupresores de forma exitosa ya que a la fecha la paciente presenta inactiva la enfermedad. El propósito de este manuscrito es mostrar una de las localizaciones más extrañas de esta entidad patológica en la cavidad oral, sus características clínicas e histológicas, establecer de forma correcta el diagnóstico diferencial con otras entidades patológicas malignas ó benignas y así emplear el tratamiento requerido para la forma en que se presente la misma...
Sujets)
Humains , Femelle , Adulte d'âge moyen , Maladies de la bouche/anatomopathologie , Maladies de la bouche/traitement médicamenteux , Granulome à plasmocytes/anatomopathologie , Granulome à plasmocytes/traitement médicamenteux , Biopsie , Diagnostic différentiel , Immunosuppresseurs/usage thérapeutiqueRésumé
No abstract available.
Sujets)
Adulte , Humains , Mâle , Carcinome hépatocellulaire/imagerie diagnostique , Granulome à plasmocytes/anatomopathologie , Maladies du foie/anatomopathologie , Tumeurs du foie/imagerie diagnostique , Imagerie par résonance magnétique , TomodensitométrieRésumé
Plasma cell granuloma is a rare reactive lesion composed of polyclonal plasma cells. It manifests primarily in the lungs, but may occur in various other anatomic locations like the oral cavity. Intraoral plasma cell granulomas involving the tongue, lip, oral mucosa and gingiva have been reported in the past. This case presents a 54-year-old female with chronic periodontitis and mandibular anterior gingival overgrowth treated by Phase I therapy (scaling and root planing) and excisional biopsy. Histological examination revealed inflammatory cell infiltrate containing sheets of plasma cells. Immunohistochemistry for kappa and lambda light chains showed a polyclonal staining pattern confirming a diagnosis of plasma cell granuloma. This case highlights the need to biopsy for unusual lesions to rule out potential neoplasms.
Sujets)
Parodontite chronique/diagnostic , Diagnostic différentiel , Femelle , Maladies de la gencive/diagnostic , Maladies de la gencive/anatomopathologie , Croissance exagérée de la gencive/diagnostic , Granulome à plasmocytes/diagnostic , Granulome à plasmocytes/anatomopathologie , Humains , Chaines légères kappa des immunoglobulines/analyse , Chaines lambda des immunoglobulines/analyse , Adulte d'âge moyenRésumé
Inflammatory pseudotumor is an unusual quasineoplastic lesion, of uncertain natural history and etiopathogenesis, which consists of inflammatory cells and myofibroblastic spindle cells; and is usually found in children and young adults. Clinical manifestations and radiological feature of this rare entity, can be indistinguishable from a malignant sarcomatous or lymphoproliferative disorders. Here, a case of surgically proven inflammatory pseudotumor of the omentum in a child and its review of literature is presented. Conservative surgery is curative in most cases of inflammatory pseudotumors. Awareness of this lesion is essential for clinicians, radiologists and pathologists, as pre-operative recognition may spare the child from unnecessary radical surgery or harmful chemoradiotherapy.
Sujets)
Enfant d'âge préscolaire , Granulome à plasmocytes/anatomopathologie , Granulome à plasmocytes/chirurgie , Humains , Mâle , Omentum/anatomopathologie , Maladies rares , Résultat thérapeutiqueRésumé
Inflammatory pseudotumor, also known as inflammatory myofibroblastic tumor and plasma cell granuloma, is an uncommon low-grade lesion composed of spindle cells admixed with mature plasma cells and other inflammatory cells, such as histiocytes, lymphocytes, and eosinophils. Here, we describe the mammographic and ultrasonographic findings of a case of an inflammatory pseudotumor of the breast in a 60-year-old woman. With the suspicion of malignancy, core needle biopsy and surgical excision confirmed the mass as being an inflammatory pseudotumor of the breast.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Biopsie , Maladies du sein/anatomopathologie , Diagnostic différentiel , Granulome à plasmocytes/anatomopathologie , Mammographie , Échographie mammaireRésumé
El síndrome de tolosa-Hunt es una oftalmoplejia dolorosa, recurrente provocada por una inflamación granulomatosa inespecífica que afecta al seno cavernoso, la hendidura esfenoidal y el apex orbitario. Se caracteriza por dolor retrocular agudo recurrente con parálisis extraocular, que generalmente afecta los nervios craneanos tercero, cuarto, quinto y sexto. Se le atribuye a una infiltración granulomatosa del apex orbitrario o en el seno cavernoso, que responde a la corticoideoterapia. Nuestro paciente consulta por enfermedad de 3 meses de evolución presenta de forma súbita cefalea de fuerte intensidad; y pulsátil acompañado de dolor de fuerte intensidad en globo ocular derecho de carácter pulsátil y progresivamente ptosis palpebral derecha. Se le instaura tratamiento con corticoides, AINES y antiglaucomatosos con poca mejoría sin recuperar amaurosis del ojo derecho. Se obtienen estudios por TAC y RNM de órbita donde se evidencia engrosamiento a nivel del seno cavernoso. Evaluado por equipo multidisciplinario de oftalmología, neurocirugía, Medicina Interna, Imagenología. Considerando que existe un predominio por el seno cavernoso. No se disponen de estudios de prevalencia o incidencia. Se ubica el síndrome de Tolosa-Hunt como la tercera causa de síndrome del seno cavernoso, superado por el trauma y los tumores.
Sujets)
Humains , Mâle , Sujet âgé de 80 ans ou plus , Blépharoptose/diagnostic , Céphalée/diagnostic , Hormones corticosurrénaliennes/usage thérapeutique , Douleur/diagnostic , Spectroscopie par résonance magnétique/méthodes , Granulome à plasmocytes/anatomopathologie , Sinus caverneux/anatomie et histologie , Sinus sphénoïdal/physiopathologie , Syndrome de Tolosa-Hunt/anatomopathologie , Angiographie cérébrale/méthodes , Cécité/étiologie , Hormones corticosurrénaliennes/pharmacologie , Inflammation/étiologie , Nerfs crâniens/anatomie et histologie , Ophtalmologie , Maladies de l'oeil/anatomopathologieRésumé
We present a biopsy proven case of 47 years-old man with a carotid pseudotumor, clinically presented as carotidynia. CT showed a mass encasing and narrowing the common carotid artery and MRI showed hypointense signal in T2 and intense enhancement after contrast media administration. The patient was suspected to have an inflammatory process and steroids were prescribed. Eight days after the steroid treatment significant radiological and clinical improvement was observed. The patient remains free of symptoms.
Apresentamos um caso comprovado por biópsia de pseudotumor carotídeo em um homem de 47 anos, com apresentação clínica de carotidinia. A TC mostrou massa envolvendo e estenosando a artéria carótida comum direita e a RM apresentava lesão com hipossinal em T2 e importante realce com o uso de meio de contraste paramagnético. O paciente recebeu a hipótese de lesão inflamatória e um tratamento com corticosteróides foi iniciado. Após oito dias de tratamento uma melhora clínica e radiológica significativas foram observadas. O paciente permanece assintomático.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Artériopathies carotidiennes/diagnostic , Artère carotide commune/anatomopathologie , Granulome à plasmocytes/diagnostic , Biopsie , Artériopathies carotidiennes/anatomopathologie , Artériopathies carotidiennes/chirurgie , Diagnostic différentiel , Granulome à plasmocytes/anatomopathologie , Granulome à plasmocytes/chirurgie , Imagerie par résonance magnétique , TomodensitométrieRésumé
No abstract available.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Granulome à plasmocytes/anatomopathologie , Foie/anatomopathologie , Maladies du foie/anatomopathologieRésumé
An exceedingly rare case of gingival plasma cell granuloma is reported in a 40-year old female patient. The case presented as an exophytic mass of gingiva, clinically resembling traumatic fibroma. Histopathologic findings revealed dense sheets of plasma cells infiltrate. Immunohistochemistry for kappa and lambda light chains showed polyclonal (benign) staining pattern confirming a diagnosis of plasma cell granuloma. It is important to recognise this peculiar lesion because of its highly unusual incidence in involving the periodontium. Clinical features are usually suggestive of traumatic fibroma (benign) but histopathologicaly in early stages it closely resembles plasmacytoma (malignant). This case highlights the need to biopsy unusual lesions to rule out potential neoplasms and also emphasizes the need to submit all the excised tissue for histological examination regardless of clinical impression and/or perceived surgical success. Only by such practice can rare lesion of this type be diagnosed and their incidence studied.
Sujets)
Adulte , Diagnostic différentiel , Femelle , Fibrome/diagnostic , Études de suivi , Maladies de la gencive/anatomopathologie , Tumeur de la gencive/diagnostic , Granulome à plasmocytes/anatomopathologie , Humains , Plasmocytome/diagnosticRésumé
CONTEXTO: Pseudotumor inflamatório é uma lesão benigna rara que pode se desenvolver em uma grande variedade de órgãos. Sua grande importância na prática médica reside na enorme dificuldade de distingui-lo tanto clinicamente quanto radiologicamente de condições malignas. RELATO DE CASO: Os autores relatam um caso de pseudotumor envolvendo o baço e apresentando-se concomitantemente a um carcinoma renal de células claras. Apesar da semelhança macroscópica a tumores malignos, as características inflamatórias do pseudotumor são facilmente evidenciadas à microscopia. Apesar de hipóteses terem sido formuladas, os mecanismos patogenéticos relacionados ao pseudotumor ainda não estão bem estabelecidos.
Sujets)
Humains , Mâle , Sujet âgé , Néphrocarcinome/anatomopathologie , Granulome à plasmocytes/anatomopathologie , Tumeurs du rein/anatomopathologie , Maladies de la rate/anatomopathologie , Néphrocarcinome/complications , Diagnostic différentiel , Granulome à plasmocytes/complications , Immunohistochimie , Tumeurs du rein/complications , Photomicrographie , Maladies de la rate/complications , TomodensitométrieRésumé
Se describe un caso de pseudotumor inflamatorio esplénico en un niño de 4 años. Los hallazgos clínicos fueron limitados a: dolor abdominal difuso y tumoración palpable en hipocondrio izquierdo. La ecografía y la TC mostraron una masa sólida homogénea en el polo inferior del bazo, con captación irregular del contraste endovenoso. Se realizó esplenectomía laparoscópica con diagnóstico histopatológico de pseudotumor inflamatorio. Esta localización es extremadamente rara, especialmente en niños, siendo este el cuarto caso reportado en pacientes pediátricos y el de menor edad
Sujets)
Humains , Mâle , Enfant d'âge préscolaire , Granulome à plasmocytes , Tumeurs spléniques , Douleur abdominale , Granulome à plasmocytes/anatomopathologie , Granulome à plasmocytes , Marqueurs biologiques tumoraux , Rate , TomodensitométrieRésumé
Descrevem-se pela primeira vez achados anátomo-histopatológicos da inflamaçäo pseudotumoral do baço, caracterizados pela presença de células inflamatórias, neutrófilos, linfócitos, plasmócitos, macrófagos e células gigantes multinucleadas, em uma cadela sem raça definida, de 10 anos de idade
Sujets)
Animaux , Femelle , Chiens , Granulome à plasmocytes/anatomopathologie , RateRésumé
Focal myositis is a rare idiopathic form of inflammatory myositis involving a single muscle. The presentation is often as a soft tissue pseudotumour. Magnetic resonance imaging (MRI) is a useful noninvasive imaging modality to demonstrate focal nature of the lesion. We describe three patients presenting as pseudotumour of the lower leg. MRI showed hyperintense signals in the involved muscle.