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Inflammatory myofibroblastic tumours of the thorax: Radiologic and clinicopathological correlation
CONTEXT AND AIMS: Inflammatory myofibroblastic tumour (IMT) is a rare mesenchymal neoplasm with intermediate malignant potential. The aim of this study is to describe and compare the clinical presentation, computed tomography (CT) findings and anaplastic lymphoma kinase -1 (ALK-1) expression of IMT...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694718/ https://www.ncbi.nlm.nih.gov/pubmed/33273759 http://dx.doi.org/10.4103/ijri.IJRI_93_20 |
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author | Irodi, Aparna Chacko, Binita R Prajapati, Anand Prabhu, Anne J Vimala, Leena R Christopher, Devasahayam J Gnanamuthu, Birla R |
author_facet | Irodi, Aparna Chacko, Binita R Prajapati, Anand Prabhu, Anne J Vimala, Leena R Christopher, Devasahayam J Gnanamuthu, Birla R |
author_sort | Irodi, Aparna |
collection | PubMed |
description | CONTEXT AND AIMS: Inflammatory myofibroblastic tumour (IMT) is a rare mesenchymal neoplasm with intermediate malignant potential. The aim of this study is to describe and compare the clinical presentation, computed tomography (CT) findings and anaplastic lymphoma kinase -1 (ALK-1) expression of IMT of the thorax in children and adults. We also sought to study the tumour behaviour after treatment on the follow-up imaging. MATERIALS AND METHOD: This is a retrospective observational study of 22 histopathologically proven cases of IMT in the thorax. The clinical parameters, CT findings, biopsy results, treatment received and follow-up were recorded. Statistical analysis was performed using Fisher's exact test. RESULTS: IMT of the thorax had diverse imaging appearances, presenting either as large invasive lung masses with or without calcifications or as smaller endobronchial lesions. Children commonly presented with long duration fever (P = 0.02) and large invasive lung masses (P = 0.026), whereas adults presented with long duration haemoptysis (P = 0.001) and endobronchial lesions or smaller lung parenchymal lesions. Calcifications were more common in children (P = 0.007). ALK-1 was positive in 40% of children and 18.2% of adults (P = 0.547). Endobronchial lesions showed a trend for ALK-1 negativity. Patients with bronchoscopic excision had local recurrence and patients with surgical wedge resection had metastatic brain lesions as compared to those with lobectomy and pneumonectomy (P = 0.0152). A patient with unresectable lung mass had malignant transformation to spindle cell sarcoma after 9.5 years. CONCLUSIONS: Thoracic IMT presents with some distinct clinical and CT findings in adults and children. The CT findings and management options have implications for prognosis. If resectable, lobectomy is a better option than wedge resection or bronchoscopic excision for preventing local recurrence and metastasis. IMT can undergo malignant transformation. |
format | Online Article Text |
id | pubmed-7694718 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-76947182020-12-02 Inflammatory myofibroblastic tumours of the thorax: Radiologic and clinicopathological correlation Irodi, Aparna Chacko, Binita R Prajapati, Anand Prabhu, Anne J Vimala, Leena R Christopher, Devasahayam J Gnanamuthu, Birla R Indian J Radiol Imaging Chest Imaging CONTEXT AND AIMS: Inflammatory myofibroblastic tumour (IMT) is a rare mesenchymal neoplasm with intermediate malignant potential. The aim of this study is to describe and compare the clinical presentation, computed tomography (CT) findings and anaplastic lymphoma kinase -1 (ALK-1) expression of IMT of the thorax in children and adults. We also sought to study the tumour behaviour after treatment on the follow-up imaging. MATERIALS AND METHOD: This is a retrospective observational study of 22 histopathologically proven cases of IMT in the thorax. The clinical parameters, CT findings, biopsy results, treatment received and follow-up were recorded. Statistical analysis was performed using Fisher's exact test. RESULTS: IMT of the thorax had diverse imaging appearances, presenting either as large invasive lung masses with or without calcifications or as smaller endobronchial lesions. Children commonly presented with long duration fever (P = 0.02) and large invasive lung masses (P = 0.026), whereas adults presented with long duration haemoptysis (P = 0.001) and endobronchial lesions or smaller lung parenchymal lesions. Calcifications were more common in children (P = 0.007). ALK-1 was positive in 40% of children and 18.2% of adults (P = 0.547). Endobronchial lesions showed a trend for ALK-1 negativity. Patients with bronchoscopic excision had local recurrence and patients with surgical wedge resection had metastatic brain lesions as compared to those with lobectomy and pneumonectomy (P = 0.0152). A patient with unresectable lung mass had malignant transformation to spindle cell sarcoma after 9.5 years. CONCLUSIONS: Thoracic IMT presents with some distinct clinical and CT findings in adults and children. The CT findings and management options have implications for prognosis. If resectable, lobectomy is a better option than wedge resection or bronchoscopic excision for preventing local recurrence and metastasis. IMT can undergo malignant transformation. Wolters Kluwer - Medknow 2020 2020-10-15 /pmc/articles/PMC7694718/ /pubmed/33273759 http://dx.doi.org/10.4103/ijri.IJRI_93_20 Text en Copyright: © 2020 Indian Journal of Radiology and Imaging http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Chest Imaging Irodi, Aparna Chacko, Binita R Prajapati, Anand Prabhu, Anne J Vimala, Leena R Christopher, Devasahayam J Gnanamuthu, Birla R Inflammatory myofibroblastic tumours of the thorax: Radiologic and clinicopathological correlation |
title | Inflammatory myofibroblastic tumours of the thorax: Radiologic and clinicopathological correlation |
title_full | Inflammatory myofibroblastic tumours of the thorax: Radiologic and clinicopathological correlation |
title_fullStr | Inflammatory myofibroblastic tumours of the thorax: Radiologic and clinicopathological correlation |
title_full_unstemmed | Inflammatory myofibroblastic tumours of the thorax: Radiologic and clinicopathological correlation |
title_short | Inflammatory myofibroblastic tumours of the thorax: Radiologic and clinicopathological correlation |
title_sort | inflammatory myofibroblastic tumours of the thorax: radiologic and clinicopathological correlation |
topic | Chest Imaging |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694718/ https://www.ncbi.nlm.nih.gov/pubmed/33273759 http://dx.doi.org/10.4103/ijri.IJRI_93_20 |
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