Diagnosis and Treatment of Intestinal Inflammatory Pseudotumor(63 Cases Attached)

Abstract

Objective To investigate the clinicopathologic characteristics、diagnosis and treatment of intestinal inflammatory pseudotumor(IIP).Methods Clinical data of 63 cases with IIP were collected in which 2 cases treated in Guangzhou General Hospital of Guangzhou Military Command and other 61cases reviewed from literature reported sporadically in recent years.Clinical manifestations,imageology examination,endoscope examination,pathologic diagnosis,therapeutic method and effect were analyzed and summarized.Results IIP occurs most often in adults,more common in men.The main symptoms is abdominal pain and tumor,often accompany fever,but no anemia.Most mass are solitary localized displayed in imageology examination(93.7%,59/63).Abdominal sacculated or solid mass was detected by B-ultrasonography,accompanying calcification.Two cases in our hospital display medium enhancement,asymmetrical,progressive,tardive in masses by CT.Barium enema showed enteric cavity irregularity or circular filling-defect and narrow but barium can pass through,accompanying smoothed margin and intact mucosa.Enteroscopy examination showed a majority of masses growth protrudent in intestines and intact mucosa(71.4%,20/28),mucosa moderate and severe chronic inflammatory in pathology,and partial is ulcer mass.Pathological examination: Hyperplasia of spindle cells and chronic inflammatory cells,include lymphocytes,plasma cells,collagen fibrils,were observed by microscope.Immunohistochemistry showed positive expression in Vimentin,SMA,MSA;63 patients all underwent operation.There were no relapses or metastases during three months to four years follow-up after operation.Conclusion IIP is a rare mesenchymal tumor without clinical characteristic.Imageology and endoscopic checks don′t show characteristics.But IIP has certain characteristics after synthetic analysis.It is easy to misdiagnosed as malignant tumors before surgery.Accurate diagnosis rely on immunohistochemistry and pathological examination.The effective treatment to IIP is operation,which has a good prognosis.