Nasal sinus inflammatory myofibroblastic tumor:four cases report and literature review / 中国医师进修杂志

ABSTRACT

Objective To investigate clinical, pathological and radiographic features of inflammatory myofibroblastic tumor (IMT) of the nasal cavity. Methods Four cases of pathologically confirmed IMT in the Shengjing hospital of China Medical University from April 2015 to April 2017 were retrospectively analyzed. Three dimensional CT and enhanced MRI was performed in all patients. Results The main symptoms were local obstruction, oppression or infringement. In 4 cases, IMT was single, with 2 cases of primary maxillary sinus, 1 case of nasal cavity, and 1 case of nasal septum;Pathological morphology presented diversity, consisting mainly of spindle-shaped cells which distributed in bundles or whirlpools, and showed inflammatory cell infiltration. Immunohistochemical results showed SMA (+) in 4 cases, Desmin (-) in 4 cases , and ALK (-) in 3 cases. CT plain tumors showed mostly uniform soft tissue densities. MR showed more enhancement of tumors, 1 case with necrotic cystic changes in the maxillary sinus IMT tumors, showed a significant ring after enhancement. Conclusions The IMT of nasal cavity and paranasal sinuses is rare and the clinical symptoms are non-specific. The diagnosis mainly depends on pathological examination and immunohistochemical staining. Preoperative CT and MRI examinations can not only provide information on the lesion location, extent, and adjacent tissue invasion, but also on the blood supply of the tumor and the internal components of the tissue, which will facilitate the choice of treatment options.