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Original Article
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Immunohistochemical expression in idiopathic inflammatory myopathies at a single center in Vietnam
Dat Quoc Ngo, Si Tri Le, Khanh Hoang Phuong Phan, Thao Thi Phuong Doan, Linh Ngoc Khanh Nguyen, Minh Hoang Dang, Thien Thanh Ly, Thu Dang Anh Phan
J Pathol Transl Med. 2024;58(4):174-181.   Published online June 25, 2024
DOI: https://doi.org/10.4132/jptm.2024.05.02
  • 1,139 View
  • 226 Download
AbstractAbstract PDF
Background
The identification of idiopathic inflammatory myopathies (IIMs) requires a comprehensive analysis involving clinical manifestations and histological findings. This study aims to provide insights into the histopathological and immunohistochemical aspects of IIMs.
Methods
This retrospective case series involved 56 patients diagnosed with IIMs at the Department of Pathology, University of Medicine and Pharmacy at Ho Chi Minh City, from 2019 to 2023. The histology and immunohistochemical expression of HLA-ABC, HLA-DR, C5b-9, Mx1/2/3, and p62 were detected.
Results
We examined six categories of inflammatory myopathy, including immunemediated necrotizing myopathy (58.9%), dermatomyositis (DM; 23.2%), overlap myositis (8.9%), antisynthetase syndrome (5.4%), inclusion body myositis (IBM; 1.8%), and polymyositis (1.8%). The average age of the patients was 49.7 ± 16.1 years, with a female-to-male ratio of 3:1. Inflammatory cell infiltration in the endomysium was present in 62.5% of cases, perifascicular atrophy was found in 17.8%, and fiber necrosis was observed in 42 cases (75.0%). Rimmed vacuoles were present in 100% of cases in the IBM group. Immunohistochemistry showed the following positivity rates: HLA-ABC (89.2%), HLA-DR (19.6%), C5b-9 (57.1%), and Mx1/2/3 (10.7%). Mx1/2/3 expression was high in DM cases. p62 vacuole deposits were noted in the IBM case. The combination of membrane attack complex and major histocompatibility complex I helped detect IIMs in 96% of cases.
Conclusions
The diagnosis of IIMs and their subtypes should be based on clinical features and histopathological characteristics. Immunohistochemistry plays a crucial role in the diagnosis and differentiation of these subgroups.
Case Study
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Primary epithelioid inflammatory myofibroblastic sarcoma of the brain with EML4::ALK fusion mimicking intra-axial glioma: a case report and brief literature review
Eric Eunshik Kim, Chul-Kee Park, Koung Mi Kang, Yoonjin Kwak, Sung-Hye Park, Jae-Kyung Won
J Pathol Transl Med. 2024;58(3):141-145.   Published online May 14, 2024
DOI: https://doi.org/10.4132/jptm.2024.04.12
  • 1,664 View
  • 179 Download
AbstractAbstract PDF
An aggressive subtype of inflammatory myofibroblastic tumor, epithelioid inflammatory myofibroblastic sarcoma occurs primarily inside the abdominal cavity, followed by a pulmonary localization. Most harbor anaplastic lymphoma kinase (ALK) gene rearrangements, with RANBP2 and RRBP1 among the well-documented fusion partners. We report the second case of primary epithelioid inflammatory myofibroblastic sarcoma of the brain, with a well-known EML4::ALK fusion. The case is notable for its intra-axial presentation that clinico-radiologically mimicked glioma.
Review
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Inflammatory bowel disease–associated intestinal fibrosis
Ji Min Park, Jeongseok Kim, Yoo Jin Lee, Sung Uk Bae, Hye Won Lee
J Pathol Transl Med. 2023;57(1):60-66.   Published online January 10, 2023
DOI: https://doi.org/10.4132/jptm.2022.11.02
  • 6,569 View
  • 326 Download
  • 16 Web of Science
  • 15 Crossref
AbstractAbstract PDF
Fibrosis is characterized by a proliferation of fibroblasts and excessive extracellular matrix following chronic inflammation, and this replacement of organ tissue with fibrotic tissue causes a loss of function. Inflammatory bowel disease (IBD) is a chronic inflammation of the gastrointestinal tract, and intestinal fibrosis is common in IBD patients, resulting in several complications that require surgery, such as a stricture or penetration. This review describes the pathogenesis and various factors involved in intestinal fibrosis in IBD, including cytokines, growth factors, epithelial-mesenchymal and endothelial-mesenchymal transitions, and gut microbiota. Furthermore, histopathologic findings and scoring systems used for stenosis in IBD are discussed, and differences in the fibrosis patterns of ulcerative colitis and Crohn’s disease are compared. Biomarkers and therapeutic agents targeting intestinal fibrosis are briefly mentioned at the end.

Citations

Citations to this article as recorded by  
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    M. Seco-Cervera, D. Ortiz-Masiá, D.C. Macias-Ceja, S. Coll, L. Gisbert-Ferrándiz, J. Cosín-Roger, C. Bauset, M. Ortega, B. Heras-Morán, F. Navarro-Vicente, M. Millán, J.V. Esplugues, S. Calatayud, M.D. Barrachina
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  • Characterization of patient-derived intestinal organoids for modelling fibrosis in Inflammatory Bowel Disease
    Ilaria Laudadio, Claudia Carissimi, Noemi Scafa, Alex Bastianelli, Valerio Fulci, Alessandra Renzini, Giusy Russo, Salvatore Oliva, Roberta Vitali, Francesca Palone, Salvatore Cucchiara, Laura Stronati
    Inflammation Research.2024; 73(8): 1359.     CrossRef
  • Food additives impair gut microbiota from healthy individuals and IBD patients in a colonic in vitro fermentation model
    Irma Gonza, Elizabeth Goya-Jorge, Caroline Douny, Samiha Boutaleb, Bernard Taminiau, Georges Daube, Marie–Louise Scippo, Edouard Louis, Véronique Delcenserie
    Food Research International.2024; 182: 114157.     CrossRef
  • Epigenetic Regulation of EMP/EMT-Dependent Fibrosis
    Margherita Sisto, Sabrina Lisi
    International Journal of Molecular Sciences.2024; 25(5): 2775.     CrossRef
  • Mechanisms and therapeutic research progress in intestinal fibrosis
    Yanjiang Liu, Tao Zhang, Kejian Pan, He Wei
    Frontiers in Medicine.2024;[Epub]     CrossRef
  • Disease clearance in ulcerative colitis: A new therapeutic target for the future
    Syed Adeel Hassan, Neeraj Kapur, Fahad Sheikh, Anam Fahad, Somia Jamal
    World Journal of Gastroenterology.2024; 30(13): 1801.     CrossRef
  • Urinary Hydroxyproline as an Inflammation-Independent Biomarker of Inflammatory Bowel Disease
    Muriel Huss, Tanja Elger, Johanna Loibl, Arne Kandulski, Benedicta Binder, Petra Stoeckert, Patricia Mester, Martina Müller, Christa Buechler, Hauke Christian Tews
    Gastroenterology Insights.2024; 15(2): 486.     CrossRef
  • Inflammatory Bowel Disease: Immune Function, Tissue Fibrosis and Current Therapies
    Jesús Cosín-Roger
    International Journal of Molecular Sciences.2024; 25(12): 6416.     CrossRef
  • The Diagnosis of Intestinal Fibrosis in Crohn’s Disease—Present and Future
    Sara Jarmakiewicz-Czaja, Jolanta Gruszecka, Rafał Filip
    International Journal of Molecular Sciences.2024; 25(13): 6935.     CrossRef
  • Role of gut microbiota in Crohn’s disease pathogenesis: Insights from fecal microbiota transplantation in mouse model
    Qiang Wu, Lian-Wen Yuan, Li-Chao Yang, Ya-Wei Zhang, Heng-Chang Yao, Liang-Xin Peng, Bao-Jia Yao, Zhi-Xian Jiang
    World Journal of Gastroenterology.2024; 30(31): 3689.     CrossRef
  • Ultrasound of the bowel with a focus on IBD: the new best practice
    Christina Merrill, Stephanie R. Wilson
    Abdominal Radiology.2024;[Epub]     CrossRef
  • Unveiling the anti-inflammatory potential of 11β,13-dihydrolactucin for application in inflammatory bowel disease management
    Melanie S. Matos, María Ángeles Ávila-Gálvez, Antonio González-Sarrías, Nuno-Valério Silva, Carolina Lage Crespo, António Jacinto, Ana Teresa Serra, Ana A. Matias, Cláudia Nunes dos Santos
    Food & Function.2024; 15(18): 9254.     CrossRef
  • Pathways Affected by Falcarinol-Type Polyacetylenes and Implications for Their Anti-Inflammatory Function and Potential in Cancer Chemoprevention
    Ruyuf Alfurayhi, Lei Huang, Kirsten Brandt
    Foods.2023; 12(6): 1192.     CrossRef
  • Time to eRAASe chronic inflammation: current advances and future perspectives on renin-angiotensin-aldosterone-system and chronic intestinal inflammation in dogs and humans
    Romy M. Heilmann, Georg Csukovich, Iwan A. Burgener, Franziska Dengler
    Frontiers in Veterinary Science.2023;[Epub]     CrossRef
  • Role of the epithelial barrier in intestinal fibrosis associated with inflammatory bowel disease: relevance of the epithelial-to mesenchymal transition
    Dulce C. Macias-Ceja, M. Teresa Mendoza-Ballesteros, María Ortega-Albiach, M. Dolores Barrachina, Dolores Ortiz-Masià
    Frontiers in Cell and Developmental Biology.2023;[Epub]     CrossRef
Case Study
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Primary pulmonary epithelioid inflammatory myofibroblastic sarcoma: a rare entity and a literature review
Priyanka Singh, Aruna Nambirajan, Manish Kumar Gaur, Rahul Raj, Sunil Kumar, Prabhat Singh Malik, Deepali Jain
J Pathol Transl Med. 2022;56(4):231-237.   Published online July 7, 2022
DOI: https://doi.org/10.4132/jptm.2022.05.08
  • 3,063 View
  • 114 Download
  • 8 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is an aggressive subtype of inflammatory myofibroblastic tumor (IMT) harboring anaplastic lymphoma kinase (ALK) gene fusions and is associated with high risk of local recurrence and poor prognosis. Herein, we present a young, non-smoking male who presented with complaints of cough and dyspnoea and was found to harbor a large right lower lobe lung mass. Biopsy showed a high-grade epithelioid to rhabdoid tumor with ALK and desmin protein expression. The patient initially received 5 cycles of crizotinib and remained stable for 1 year; however, he then developed multiple bony metastases, for which complete surgical resection was performed. Histopathology confirmed the diagnosis of EIMS, with ALK gene rearrangement demonstrated by fluorescence in situ hybridization. Postoperatively, the patient is asymptomatic with stable metastatic disease on crizotinib and has been started on palliative radiotherapy. EIMS is a very rare subtype of IMT that needs to be included in the differential diagnosis of ALKexpressing lung malignancies in young adults.

Citations

Citations to this article as recorded by  
  • Mediastinal epithelioid inflammatory myofibroblastic sarcoma with the EML4‐ALK fusion: A case report and literature review
    Tingyu Pan, Xinyu Sun, Xiao Wu, Futing Tang, Xianmei Zhou, Qian Wang, Shi Chen
    Respirology Case Reports.2024;[Epub]     CrossRef
  • Primary epithelioid inflammatory myofibroblastic sarcoma of the brain with EML4::ALK fusion mimicking intra-axial glioma: a case report and brief literature review
    Eric Eunshik Kim, Chul-Kee Park, Koung Mi Kang, Yoonjin Kwak, Sung-Hye Park, Jae-Kyung Won
    Journal of Pathology and Translational Medicine.2024; 58(3): 141.     CrossRef
  • Epithelioid Inflammatory Myofibroblastic Sarcoma: A Report of a Rare Case
    Varun Ronanki, Vaddatti Tejeswini, Inuganti Venkata Renuka, Shaik Raheema, Bakkamanthala S K Kanth
    Cureus.2024;[Epub]     CrossRef
  • Thoracic epithelioid inflammatory myofibroblastic sarcoma: a rare and aggressive disease with case report and literature review
    Linke Yang, Pei Li, Runze Liu, Baomin Feng, Huiqing Mao, Xiaoyong Tang, Guangjian Yang
    Discover Oncology.2024;[Epub]     CrossRef
  • Case report: Epithelioid inflammatory myofibroblastic sarcoma treated with an ALK TKI ensartinib
    Mengmeng Li, Ruyue Xing, Jiuyan Huang, Chao Shi, Chunhua Wei, Huijuan Wang
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Epithelioid Inflammatory Myofibroblastic Sarcoma With Poor Response to Crizotinib: A Case Report
    Soheila Aminimoghaddam, Roghayeh Pourali
    Clinical Medicine Insights: Case Reports.2023;[Epub]     CrossRef
  • Epithelioid inflammatory myofibroblastic sarcoma: a case report and brief literature review
    Weidong Dou, Yu Guan, Tao Liu, Hang Zheng, Shuo Feng, Yingchao Wu, Xin Wang, Zhanbing Liu
    Frontiers in Oncology.2023;[Epub]     CrossRef
Review
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Non-conventional dysplastic subtypes in inflammatory bowel disease: a review of their diagnostic characteristics and potential clinical implications
Won-Tak Choi
J Pathol Transl Med. 2021;55(2):83-93.   Published online March 9, 2021
DOI: https://doi.org/10.4132/jptm.2021.02.17
  • 5,753 View
  • 358 Download
  • 16 Web of Science
  • 17 Crossref
AbstractAbstract PDF
The early detection and grading of dysplasia is the current standard of care to minimize mortality from colorectal cancer (CRC) in patients with inflammatory bowel disease. With the development of advanced endoscopic resection techniques, colectomy is now reserved for patients with invisible/flat dysplasia (either high-grade [HGD] or multifocal low-grade dysplasia) or endoscopically unresectable lesions. Although most pathologists are familiar with the morphologic criteria of conventional (intestinal type) dysplasia, the most well-recognized form of dysplasia, an increasing number of diagnostic material has led to the recognition of several different morphologic patterns of epithelial dysplasia. The term “non-conventional” dysplasia has been coined to describe these changes, but to date, the recognition and full appreciation of these novel forms of dysplasia by practicing pathologists is uneven. The recognition of these non-conventional subtypes is becoming increasingly important, as some of them appear to have a higher risk of developing HGD or CRC than conventional dysplasia or sporadic adenomas. This review describes the morphologic characteristics of all seven non-conventional subtypes that have been reported to date as well as our current understanding of their clinicopathologic and molecular features that distinguish them from conventional dysplasia or sporadic adenomas.

Citations

Citations to this article as recorded by  
  • Recently described types of dysplasia associated with IBD: tips and clues for the practising pathologist
    Zahra Alipour, Kristen Stashek
    Journal of Clinical Pathology.2024; 77(2): 77.     CrossRef
  • Nonconventional Dysplasia is Frequently Associated With Goblet Cell Deficient and Serrated Variants of Colonic Adenocarcinoma in Inflammatory Bowel Disease
    Andrew Xiao, Masato Yozu, Bence P. Kővári, Lindsay Yassan, Xiaoyan Liao, Marcela Salomao, Maria Westerhoff, Anita Sejben, Gregory Y. Lauwers, Won-Tak Choi
    American Journal of Surgical Pathology.2024; 48(6): 691.     CrossRef
  • Increased Active Inflammation in the Colon is Not a Reliable Predictor of an Elevated Risk of Dysplasia in Patients With Primary Sclerosing Cholangitis and Ulcerative Colitis
    Ruth Zhang, Dongliang Wang, Gregory Y. Lauwers, Won-Tak Choi
    American Journal of Surgical Pathology.2024; 48(9): 1154.     CrossRef
  • Dysplasia Detected in Patients With Serrated Epithelial Change Is Frequently Associated With an Invisible or Flat Endoscopic Appearance, Nonconventional Dysplastic Features, and Advanced Neoplasia
    Dorukhan Bahceci, Lindsay Alpert, Tanner Storozuk, Xiaoyan Liao, Masato Yozu, Maria Westerhoff, Bence P. Kővári, Gregory Y. Lauwers, Won-Tak Choi
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    Kh. M. Akhrieva, A. S. Tertychnyy, N. V. Pachuashvili, L. S. Urusova
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    Won-Tak Choi
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    Dorukhan Bahceci, Gregory Y Lauwers, Won‐Tak Choi
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    Ruth Zhang, Gregory Y Lauwers, Won-Tak Choi
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Original Article
Quilty Lesions in the Endomyocardial Biopsies after Heart Transplantation
Haeyon Cho, Jin-Oh Choi, Eun-Seok Jeon, Jung-Sun Kim
J Pathol Transl Med. 2019;53(1):50-56.   Published online December 26, 2018
DOI: https://doi.org/10.4132/jptm.2018.11.30
  • 6,251 View
  • 125 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary Material
Background
The aim of this study was to investigate the clinical significance of Quilty lesions in endomyocardial biopsies (EMBs) of cardiac transplantation patients.
Methods
A total of 1190EMBs from 117 cardiac transplantation patients were evaluated histologically for Quilty lesions,acute cellular rejection, and antibody-mediated rejection. Cardiac allograft vasculopathy wasdiagnosed by computed tomography coronary angiography. Clinical information, including thepatients’ survival was retrieved by a review of medical records.
Results
Eighty-eight patients(75.2%) were diagnosed with Quilty lesions, which were significantly associated with acute cellularrejection, but not with acute cellular rejection ≥ 2R or antibody-mediated rejection. In patientsdiagnosed with both Quilty lesions and acute cellular rejection, the time-to-onset of Quilty lesionsfrom transplantation was longer than that of acute cellular rejections. We found a significant associationbetween Quilty lesions and cardiac allograft vasculopathy. No significant relationship wasfound between Quilty lesions and the patients’ survival.
Conclusions
Quilty lesion may be an indicator of previous acute cellular rejection rather than a predictor for future acute cellular rejection.

Citations

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    Kevin C. Bermea, Nicolas Kostelecky, Sylvie T. Rousseau, Chieh-Yu Lin, Luigi Adamo
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    Costel Dumitru, Ancuta Zazgyva, Adriana Habor, Ovidiu Cotoi, Horațiu Suciu, Carmen Cotrutz, Bogdan Grecu, Ileana Anca Sin
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Reviews
A Review of Inflammatory Processes of the Breast with a Focus on Diagnosis in Core Biopsy Samples
Timothy M. D’Alfonso, Paula S. Ginter, Sandra J. Shin
J Pathol Transl Med. 2015;49(4):279-287.   Published online June 22, 2015
DOI: https://doi.org/10.4132/jptm.2015.06.11
  • 23,725 View
  • 438 Download
  • 29 Web of Science
  • 40 Crossref
AbstractAbstract PDF
Inflammatory and reactive lesions of the breast are relatively uncommon among benign breast lesions and can be the source of an abnormality on imaging. Such lesions can simulate a malignant process, based on both clinical and radiographic findings, and core biopsy is often performed to rule out malignancy. Furthermore, some inflammatory processes can mimic carcinoma or other malignancy microscopically, and vice versa. Diagnostic difficulty may arise due to the small and fragmented sample of a core biopsy. This review will focus on the pertinent clinical, radiographic, and histopathologic features of the more commonly encountered inflammatory lesions of the breast that can be characterized in a core biopsy sample. These include fat necrosis, mammary duct ectasia, granulomatous lobular mastitis, diabetic mastopathy, and abscess. The microscopic differential diagnoses for these lesions when seen in a core biopsy sample will be discussed.

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Advances in the Endoscopic Assessment of Inflammatory Bowel Diseases: Cooperation between Endoscopic and Pathologic Evaluations
Jae Hee Cheon
J Pathol Transl Med. 2015;49(3):209-217.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.04.09
  • 12,015 View
  • 95 Download
  • 5 Web of Science
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AbstractAbstract PDF
Endoscopic assessment has a crucial role in the management of inflammatory bowel disease (IBD). It is particularly useful for the assessment of IBD disease extension, severity, and neoplasia surveillance. Recent advances in endoscopic imaging techniques have been revolutionized over the past decades, progressing from conventional white light endoscopy to novel endoscopic techniques using molecular probes or electronic filter technologies. These new technologies allow for visualization of the mucosa in detail and monitor for inflammation/dysplasia at the cellular or sub-cellular level. These techniques may enable us to alter the IBD surveillance paradigm from four quadrant random biopsy to targeted biopsy and diagnosis. High definition endoscopy and dye-based chromoendoscopy can improve the detection rate of dysplasia and evaluate inflammatory changes with better visualization. Dye-less chromoendoscopy, including narrow band imaging, iScan, and autofluorescence imaging can also enhance surveillance in comparison to white light endoscopy with optical or electronic filter technologies. Moreover, confocal laser endomicroscopy or endocytoscopy have can achieve real-time histology evaluation in vivo and have greater accuracy in comparison with histology. These new technologies could be combined with standard endoscopy or further histologic confirmation in patients with IBD. This review offers an evidence-based overview of new endoscopic techniques in patients with IBD.

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Case Study
Follicular Dendritic Cell Sarcoma of the Inflammatory Pseudotumor-like Variant Presenting as a Colonic Polyp
Shien-Tung Pan, Chih-Yuan Cheng, Nie-Sue Lee, Peir-In Liang, Shih-Sung Chuang
Korean J Pathol. 2014;48(2):140-145.   Published online April 28, 2014
DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.2.140
  • 9,145 View
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  • 32 Crossref
AbstractAbstract PDF

Follicular dendritic cell (FDC) sarcoma is rare and is classified either as conventional type or inflammatory pseudotumor (IPT)-like variant. Extranodal presentation is uncommon and nearly all gastrointestinal FDC tumors are of the conventional type. IPT-like variant tumors occur almost exclusively in the liver and spleen and are consistently associated with Epstein-Barr virus (EBV). Here we report the case of a 78-year-old woman with an IPT-like FDC sarcoma presenting as a pedunculated colonic polyp. Histologically, scanty atypical ovoid to spindle cells were mixed with a background of florid lymphoplasmacytic infiltrate, which led to an initial misdiagnosis of pseudolymphoma. These atypical cells expressed CD21, CD23, CD35, and D2-40, and were positive for EBV by in situ hybridization, confirming the diagnosis. The patient was free of disease five months after polypectomy without adjuvant therapy. Although extremely rare, the differential diagnosis for colonic polyp should include FDC sarcoma to avoid an erroneous diagnosis. A review of the 24 cases of IPT-like FDC sarcoma reported in the literature reveal that this tumor occurs predominantly in females with a predilection for liver and spleen, and has a strong association with EBV.

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Original Article
Inflammatory Pseudotumor of the Urinary Bladder: An Immunohistochemical and Ultrastructural Study.
Seung Sam Paik, Joo Seob Keum, Moon Hyang Park, Jung Dal Park
Korean J Pathol. 1996;30(5):447-452.
  • 1,585 View
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AbstractAbstract PDF
Inflammatory pseudotumor of the urinary bladder is an unusual, benign mesenchymal proliferative lesion of the submucosal stroma easily mistaken for a malignant neoplasm clinically and histologically. We present a case and describe the clinical presentation and radiologic, histologic, histochemical, immunohistochemical, and ultrastructural findings. A 23-year old patient presented with sudden onset of gross painless hematuria for 3 months. There was no previous instrumentation or surgery involving the genitourinary tract. Cystoscopy revealed a large polypoid and ulcerated bladder mass. The lesion consisted of plump spindle shaped, fibroblast-like cells embedded in a myxoid stroma. Mitotic figures were negligible and the lesion showed encroachment on the superficial muscle bundles. The spindle cells were immunoreactive for vimentin and muscle specific actin. Immunohistochemical and ultrastructural findings revealed the fibroblastic-myofibroblastic nature of this lesion. Complete surgical excision by partial cystectomy was successful in eradicating the lesion. The findings are described with a discussion of the pathogenesis and review of the literature.
Case Reports
Inflammatory Myofibroblastic Tumor in Posterior Mediastinum.
Seung Sam Paik, Seok Hoon Jeon, Se Jin Jang, Moon Hyang Park, Jung Dal Lee
Korean J Pathol. 1997;31(1):63-67.
  • 1,693 View
  • 22 Download
AbstractAbstract PDF
Inflammatory myofibroblastic tumor(IMT) or inflammatory pseudotumor is a rare, solid tumor that most often affects children. This tumor is characterized by a spindle cell proliferation admixed with a variety of inflammatory cells. Although it has disputed nosology, a distinctive fibroinflammatory and even pseudosarcomatous appearance have been well appreciated. Herein, we report a case of IMT in the posterior mediastinum in a 19-year-old girl with clinical findings. The immunohistochemical and ultrastructural studies on the tumor cells are reported, and their distinctive characteristics are discussed in details.
Inflammatory Pseudotumor of the Kidney.
Hwa Eun Oh, Jeong Seok Moon, Sung Jin Cho, Nam Hee Won
Korean J Pathol. 1997;31(6):592-594.
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AbstractAbstract PDF
Inflammatory pseudotumor, originally described in the lung, is a relatively rare tumor-like lesion that occurs in various organs and tissues. It is usually well demarcated from the surrounding tissue, however it can be unfortunately resected as a malignant tumor. A few inflammtory pseudotumor in the kidney have been reported in English literature, but there have been no reports in Korea. We report a case with inflammatory pseudotumor of the kidney. A 48 year old woman had an intermittent flank pain on the right side. An ultrasonographic study suggested a renal cell carcinoma and a nephrectomy was done. Grossly, there were two separate masses with a well demarcated yellowish appearance, measuring 2.3 cm and 1.3 cm in diameter, respectively. Histologically, they were composed of smooth muscle actin positive spindle cells and a large number of foamy histiocytes, lymphocytes, and plasma cells in the fibrotic backgound.
Original Articles
Cytomegalovirus Infection in Idiopathic Inflammatory Bowel Disease: Clinicopathologic Analysis of 6 Cases.
Won Ae Lee, Hye Sung Hahn, Woo Ho Kim, Yong Il Kim
Korean J Pathol. 1998;32(2):125-130.
  • 1,778 View
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AbstractAbstract PDF
Cytomegalovirus (CMV) infection is an uncommon association with idiopathic inflammatory bowel disease (IBD) often leading to a variety of serious complications. A total of 41 resected cases of IBD were examined to elucidate the pathologic features of intestinal CMV infection which was assessed by histologic examination and confirmed by immunohistochemistry with CMV antibody. Six cases were positve for CMV antibody; five cases in 19 ulcerative colitis (UC, 26.3%) and one case in 22 Crohn's disease (CD, 4.5%). Of 7 cases of the steroid-treated UC group, five cases were superinfected with CMV (71.4%) but none in 12 cases of the steroid-untreated UC group. All of the five CMV-positive cases in UC showed deep ulceration and transmural inflammation, while none of 10 UC cases without above features were CMV positive. Fibrinoid necrosis and thrombi were found in 83.3% of the CMV infected group, while none in the CMV-negative group of UC cases (p=0.01). We conclude that IBD, particularly UC, is susceptible to the CMV infection when steroid hormone is administered, and that deep colonic ulceration, transmural inflammation and fibrinoid necrosis of vasculature may suggest superinfection of CMV in UC patients. It seems that deep colonic ulceration may be the consequence of an ischemic change following vascular luminal occlusion or vasculitis by CMV infection.
Immunohistochemical Findings in 10 Cases of Inflammatory Myofibroblastic Tumor.
Soo Jin Jung, Mi Seon Kang, Chang Hoon Lee, Sook Hee Hong, Hye Kyoung Yoon
Korean J Pathol. 1999;33(9):717-722.
  • 1,876 View
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AbstractAbstract PDF
A wide range of denomination has been used for inflammatory myofibroblastic tumor (IMT). IMT is not entirely homogeneous, even though it shows some overlapping histologic features such as haphazard proliferation of spindle cell and polymorphic chronic inflammatory cell infiltraion. The spindle cell is considered to be of myofibroblastic origin but follicular dendritic cell origin was reported recently. IMT is known as nonneoplastic, aberrant inflammatory response. However, IMT could show local invasion, recurrence, vascular invasion, and malignant transformation, and clonal characteristics and aneuploidy of IMT support the hypothesis that IMT may be a neoplastic process. In order to define the nature of spindle cell of IMT, immunohistochemical stains for smooth muscle actin (SMA), vimentin (VMT), lysozyme, S-100 protein, cytokeratin, CD21 were done. Additional immunohistochemical stains for MIB-1 for proliferating activity and LMP (latent membrane protein) for Epstein-Barr virus (EBV) were done. IMTs were composed of each 2 cases from lung, liver and lymph node and one case from common bile duct, maxillary sinus, bladder and thigh, and were histologically subclassified according to Coffin et al. Nine cases (90%) were positive for SMA and VMT, but no correlation between SMA and VMT immunoreactivity and histologic types was identified. Five cases (50%) were positive for lysozyme and S-100 protein, and histologic type III was negative for lysozyme and S-100 protein, and immunoreactivity for S-100 protein was different according to the histologic subtypes. All 11 cases were negative for CD21 and EBV LMP. MIB-1 labelling index was less than 1% in all cases. In summary, the spindle cell is regarded as myofibroblastic origin rather than follicular dendritic cell origin. Relationship with EBV is not clear, and negligible MIB-1 reaction suggests that IMT might have a good prognosis.
Case Report
Inflammatory Myofibroblastic Tumor of the Mesentery: A case report.
Sung Jig Lim, Gou Young Kim, Jae Hoon Park, Youn Wha Kim, Yong Koo Park, Ju Hie Lee, Moon Ho Yang
Korean J Pathol. 1999;33(9):729-732.
  • 1,719 View
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AbstractAbstract PDF
Inflammatory myofibroblastic tumor or inflammatory pseudotumor is characterized by spindle cell proliferation with inflammatory cell infiltration, predominantly plasma cells and lymphocytes. We have experienced a case of inflammatory myofibroblastic tumor of the mesentery in a 57-year-old male patient with intermittent abdominal pain. On computer tomography, a well demarcated mass was seen in the mesenteric side of the ascending colon. Right hemicolectomy was performed under the impression of the metastatic tumor of lymph nodes. Grossly, a rather well-circumscribed gray white mass was noted in the mesentery of the ascending colon. Microscopically, the lesion consisted of plump spindle cells and accompanying inflammatory cellular infiltrates. The spindle cells were positive for vimentin.

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