Inflammatory myofibroblastic tumours: a pictorial review.

Jon Etxano Cantera,Maite Millor Muruzabal,David Cano Rafart,Paula García Barquín,Isabel Vivas Pérez,Romina Zalazar,María Páramo Alfaro

doi:10.1007/s13244-014-0370-0

Jon Etxano Cantera, Maite Millor Muruzabal + Show 5 more

Open Access

https://doi.org/10.1007/s13244-014-0370-0

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Journal: Insights into imaging	Publication Date: Dec 18, 2014
Citations: 47	License type: CC BY 4.0

Affiliation: Clinica Universidad de Navarra

Abstract

ObjectivesTo present the most important characteristics of inflammatory myofibroblastic tumours (IMTs) arising in different locations of the body with histological correlation.MethodsTo review the symptoms and main radiological findings of IMTs. On ultrasonography (US), these tumours can appear as hypoechoic or hyperechoic masses and a variable Doppler appearance with increased vascularity. Computed tomography (CT) and magnetic resonance (MR) are the most used imaging tools in their evaluation. On contrast-enhanced CT, IMTs can appear as homogeneous or heterogeneous lesions, with variable enhancement on delayed acquisitions due to fibrosis. These findings are also present on gadolinium contrast-enhanced MR. On T1-weighted and T2-weighted sequences, IMTs usually show low signal intensity reflecting also the presence of fibrotic tissue.ResultsTo show the main clinical symptoms and radiological features of IMTs in different locations: head and neck, lung, genitourinary, hepatic, splenic, gastrointestinal tract, mesenteric, muskuloskeletal.ConclusionsAlthough IMTs in some organs are not uncommon, they are not usually included in the differential diagnosis of masses. Their radiological features suggest malignant neoplasms, whereas they are not. Consequently, this is an underdiagnosed entity and only after an histological exam could a definitive diagnosis be achieved.Teaching Points• Their radiological features suggest malignant neoplasms, whereas they are not • CT and MR imaging are the most used tools in their evaluation • IMT is an underdiagnosed entity • The definitive diagnosis is only after histological exam

Highlights

Inflammatory myofibroblastic tumours (IMTs) constitute a rare group of neoplasms composed of a mixture of spindleshaped myofibroblasts or fibroblasts and a variable amount of inflammatory cells [1]
Many different terms have been used to refer to these tumours: plasma cell granuloma, inflammatory myofibrohistiocytic proliferation, fibroxanthoma, xanthogranuloma
The most frequently affected organs are lung and orbit [2], but they have been described in nearly every organ

Summary

Introduction

Inflammatory myofibroblastic tumours (IMTs) constitute a rare group of neoplasms composed of a mixture of spindleshaped myofibroblasts or fibroblasts and a variable amount of inflammatory cells (eosinophils, plasma cells and lymphocytes) [1]. Many different terms have been used to refer to these tumours: plasma cell granuloma, inflammatory myofibrohistiocytic proliferation, fibroxanthoma, xanthogranuloma. The most frequently affected organs are lung and orbit [2], but they have been described in nearly every organ. Different aetiologies have been proposed for IMT [3], being different chronic infections, autoimmune diseases and trauma the most accepted. Specific inflammatory diseases, such as IgG4 disease, have been recently associated [4, 5]. An aggressive behaviour with metastases has been described [3, 6, 7]

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Conclusion