SESSION TITLE: Lung Pathology 3 SESSION TYPE: Affiliate Case Report Poster PRESENTED ON: Tuesday, October 31, 2017 at 01:30 PM - 02:30 PM INTRODUCTION: Inflammatory myofibroblastic tumor (IMT) is a rare tumor predominantly found in children. IMTs can involve any organ but the lung is most frequently involved. Here, we report a case of IMT in an HIV-positive adult with hemoptysis CASE PRESENTATION: 46 year old black male with HIV was admitted with hemoptysis. He endorsed dyspnea and weight loss and was not adherent to HAART. Absolute CD4 count on admission was 15 cells/mm3 and interferon gamma release assay was negative. CXR showed a focal opacity in the right upper lobe (RUL) and CT scan demonstrated a wedge-shaped opacity in the RUL. Sputum was negative for acid-fast bacilli. Bronchoscopy demonstrated purulent secretions from the RUL and BAL yielded blood-tinged fluid with predominance of neutrophils and macrophages. Transbronchial biopsies (TBBx) demonstrated an inflammatory infiltrate of dendritic cells, multinucleated giant cells, plasma cells, and eosinophils in a background of bland spindle cells consistent with IMT. Immunohistochemical staining was positive for muscle-specific actin and negative for anaplastic lymphoma kinase (ALK-1). Acid fast staining was negative. There was focal positivity for Epstein-Barr virus (EBV) and Human Herpesvirus 8 (HHV-8). Biopsy and BAL cultures ultimately were positive for M. avium complex (MAC). He was a poor candidate for surgical resection and was discharged home on standard three-drug therapy for MAC and HAART. DISCUSSION: IMTs represent less than 1% of all lung tumors. Pathogenesis and neoplastic potential remains uncertain. Association with infections such as MAC, EBV, and HHV-8 has been reported. Complete resection is the treatment of choice for diagnostic and therapeutic purposes. Resolution has been reported with treatment of underlying infection in non-surgical candidates. Steroids and tyrosine kinase inhibition have also been used for ALK-1 positive tumors with some success. CONCLUSIONS: IMT is an uncommon clinical entity that may mimic conditions such as malignancy or an infectious processes. Here we have described a biopsy-proven IMT via TBBx in a patient with HIV and MAC infection. We identified only one other case in the literature of pulmonary IMT in an HIV-positive individual. Reference #1: S. Cambrea, G. Resul, M. Cambrea, F. Vasilescu, A. Benedetto. Pulmonary inflammatory myofibroblastic tumor in an AIDS patient. Rom J Morphol Embryol Rep, 55 (2) (2014), p 407-412. Reference #2: J. Yu, W. Li, D. Li, Z. Zhang, T. Yu. Pulmonary inflammatory myofibroblastic tumor mimics lung cancer. Thoracic Cancer, (5) (2014), p 271-274. DISCLOSURE: The following authors have nothing to disclose: Jeet Lund, Joe Pressler, Clifford Coile, Jose Lucar Lloveras, Shradha Ahuja No Product/Research Disclosure Information