Inflammatory pseudotumor in head and neck
Inflammatory pseudotumor in head and neck
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DOI：
10.1016/j.anl.2013.11.002
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发表时间：
2014-06-01
影响因子：
1.7
通讯作者：
Komune, Shizuo
中科院分区：
文献类型：
--
作者：
Segawa, Yuichi;Yasumatsu, Ryuji;Komune, Shizuo
背景：炎性假瘤（IPT）是一种以成纤维细胞增生和显著炎症成分为特征的肿瘤病变。它表现为局部良性或侵袭性病变，临床和放射学模拟肿瘤过程。从反应性病变到真正的肿瘤，许多实体都可以被诊断为IPT。IPT的诊断需要进一步阐述，并应将IPT与其他类似实体如炎性肌成纤维细胞瘤和igg4相关的硬化性疾病区分开来。病例总结：我们报告两例IPT发生在头颈部。一个发生在眼眶另一个发生在咽旁间隙。组织学上表现为肌成纤维细胞和炎症细胞聚集。免疫组化结果显示igg4阳性细胞少于IgG阳性细胞的40%，肌成纤维细胞间变性淋巴瘤激酶阴性。诊断为IPT/未另行说明。1例患者全身性给予皮质类固醇治疗，疗效良好。另一名患者接受局部皮质类固醇治疗，部分缓解，目前病情稳定，病情有限。讨论：IPT已被报道发生在不同的解剖部位，最常见于肺部。在头颈部的发病率极为罕见。IPT的治疗是有争议的，可能涉及皮质类固醇或手术切除，或两者兼而有之。类固醇耐药患者可考虑其他化疗药物和放疗。病理亚型、切除的安全性和皮质类固醇使用的安全性必须包括在治疗的决策过程中。2013爱思唯尔爱尔兰有限公司版权所有。
Background: Inflammatory pseudotumor (IPT) is a tumefactive lesion characterized by fibroblastic proliferations and a prominent inflammatory component. It behaves as a locally benign or aggressive lesion, clinically and radiologically mimicking a neoplastic process. Numerous entities can be diagnosed as IPT, from reactive lesions to true neoplasms. The diagnosis of IPT requires further elaboration, and IPT should be distinguished from other similar entities such as inflammatory myofibroblastic tumor and IgG4-related sclerosing disease.Case summary: We report two cases of IPT arising from the head and neck region. One occurred at the orbit and the other at the parapharyngeal space. Histologically, they showed aggregates of myofibroblasts and inflammatory cells. Immunohistochemically, the number of IgG4-positive cells was less than 40% of the number of IgG positive cells, and the myofibroblastic cells were negative for anaplastic lymphoma kinase. The diagnosis was IPT/not otherwise specified. One patient was treated by systemic administration of corticosteroid and had good response. The other, who was treated by local administration of corticosteroid, partially responded and is currently stable with limited disease. Discussion: IPT has been reported to occur in various anatomical sites, most commonly in the lungs. The incidence in the head and neck area is extremely rare. Treatment of IPT is controversial and may involve corticosteroids or surgical resection, or both. Other chemotherapeutic agents and radiotherapy may be considered in steroid-resistant patients. The pathological subtype, safety of resection, and safety of corticosteroid use must be included in the decision-making process for treatment. (C) 2013 Elsevier Ireland Ltd. All rights reserved.