TY - JOUR
T1 - A calcified mass within the thorax
T2 - An unusual diagnosis
AU - Panse, Prasad M.
AU - Jensen, Eric A.
AU - Cummings, Kristopher W.
AU - Jokerst, Clinton E.
AU - Gotway, Michael B.
N1 - Publisher Copyright:
© Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2016
Y1 - 2016
N2 - Inflammatory myofibroblastic tumor (IMT) is a rare proliferative lesion also referred to as an inflammatory pseudotumor, among a number of other pseudonyms. IMTs are comprised of variable amounts of spindle cells, collagen, and inflammatory cells, including plasma cells, foamy histiocytes, and lymphocytes. IMTs may affect different organ systems, but the thorax is the most commonly affected, particularly the lung or the airways, and less commonly the mediastinum. IMTs exhibit a variable biological behavior, ranging from spontaneous involution to locally aggressive behavior, including recurrence after resection, regional extension, and even distant metastatic deposits. Genetic assessment has revealed neoplastic features in some IMTs, but not others, rendering the IMT classification ambiguous. Pulmonary IMTs affect patients over a wide age range, but are most frequently encountered in children, adolescents, or young adults. IMTs are occasionally discovered asymptomatically, but may present fever, dyspnea, chest pain, or hemoptysis. Thoracic IMTs primarily present on imaging as a solitary pulmonary nodule or mass, which may show calcification: An appearance suggestive of IMT when a nodule or a mass is encountered in a young patient. The margins of thoracic IMTs range from circumscribed to lobulated or poorly defined. Intense contrast enhancement is common with IMTs, and the lesions may even be associated with aberrant systemic arterial supply, simulating pulmonary sequestration. Thoracic IMTs are usually treated with limited surgical resection, with corticosteroid therapy or radiation utilized for unresectable patients or patients with inadequate surgical margins.
AB - Inflammatory myofibroblastic tumor (IMT) is a rare proliferative lesion also referred to as an inflammatory pseudotumor, among a number of other pseudonyms. IMTs are comprised of variable amounts of spindle cells, collagen, and inflammatory cells, including plasma cells, foamy histiocytes, and lymphocytes. IMTs may affect different organ systems, but the thorax is the most commonly affected, particularly the lung or the airways, and less commonly the mediastinum. IMTs exhibit a variable biological behavior, ranging from spontaneous involution to locally aggressive behavior, including recurrence after resection, regional extension, and even distant metastatic deposits. Genetic assessment has revealed neoplastic features in some IMTs, but not others, rendering the IMT classification ambiguous. Pulmonary IMTs affect patients over a wide age range, but are most frequently encountered in children, adolescents, or young adults. IMTs are occasionally discovered asymptomatically, but may present fever, dyspnea, chest pain, or hemoptysis. Thoracic IMTs primarily present on imaging as a solitary pulmonary nodule or mass, which may show calcification: An appearance suggestive of IMT when a nodule or a mass is encountered in a young patient. The margins of thoracic IMTs range from circumscribed to lobulated or poorly defined. Intense contrast enhancement is common with IMTs, and the lesions may even be associated with aberrant systemic arterial supply, simulating pulmonary sequestration. Thoracic IMTs are usually treated with limited surgical resection, with corticosteroid therapy or radiation utilized for unresectable patients or patients with inadequate surgical margins.
KW - Inflammatory myofibroblastic tumor
KW - Inflammatory pseudotumor
KW - Mass
KW - Nodule
KW - Plasma cell granuloma
KW - Vascular neoplasm
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U2 - 10.1097/CPM.0000000000000140
DO - 10.1097/CPM.0000000000000140
M3 - Article
AN - SCOPUS:84952837825
SN - 1068-0640
VL - 23
SP - 47
EP - 52
JO - Clinical Pulmonary Medicine
JF - Clinical Pulmonary Medicine
IS - 1
ER -