131/541. Intramedullary plasma cell granuloma in the cervicothoracic spine. Case report. Intraspinal plasma cell granuloma, which is a nonneoplastic entity, is extremely rare. To date, only four cases have been documented in the spinal meninges. The authors report the first case of a C7-T1 intramedullary plasma cell granuloma. After excision of the lesion, the patient's gait and bladder dysfunction improved. This plasma cell granuloma initially showed no delineated mass on T1-weighted magnetic resonance (MR) images, low signal intensity on T2-weighted images, and was well enhanced after administration of gadolinium diethylenetriamine pentaacetic acid. The latter MR imaging modality should help to detect this tumorous lesion. Histologically, the granuloma needs to be distinguished from lymphoplasmacyte-rich meningioma and plasmacytoma. ( info) |
132/541. Isolated inflammatory pseudotumor of the occipital condyle. Report of two cases. Although the craniocervical junction is involved in a variety of conditions including trauma, neoplastic lesions, and inflammatory processes, isolated inflammatory conditions involving the occipital condyle exclusively are not known. The authors report this unusual condition in two cases. Unless the patient is of poor medical risk, excision of the lesion is the treatment of choice to decompress the neural structures. ( info) |
133/541. Cutaneous Rosai-Dorfman disease: histopathological presentation as inflammatory pseudotumor. A literature review. Purely cutaneous Rosai-Dorfman disease is exceptional. The disease is characterized histologically by large, proliferating histiocytes exhibiting inflammatory cells within their cytoplasm (emperipolesis). We present here a case of purely cutaneous generalized disease in which the routine histopathology was suggestive of an inflammatory pseudotumor. Positivity for S-100 protein, alpha1-antitrypsin, alpha1-antichymotrypsin, lysozyme, Mac387 and CD68 proteins, and negativity for CD1a protein confirmed the diagnosis of Rosai-Dorfman disease. The rarity of this case lies in the presence of conspicuous inflammatory pseudotumor-like histopathologic changes, masking an otherwise typical sinus histiocytosis cell infiltrate. This unusual presentation of the disease requires a high index of suspicion by clinicians and pathologists. ( info) |
134/541. fever of unknown origin as a presentation of gastric inflammatory myofibroblastic tumor in a two-year-old boy. Gastric inflammatory myofibroblastic tumor (IMT) is an extremely rare lesion with mimicking malignant features and accompanied with various clinical manifestations. Here we present a 2-yr-old boy who had a gastric IMT with a huge extragastric mass, which closely resembled a neuroblastoma on imaging studies. He experienced intermittent fever and poor appetite for 6 weeks. Fever remained up to 38 degrees C even on the operation day. He underwent partial gastrectomy and distal pancreatectomy with splenectomy including the tumor. The preoperative fever disappeared and did not recur in the postoperative course. ( info) |
135/541. Plasma cell granuloma in cyclosporine-induced gingival overgrowth: a report of two cases with immunohistochemical positivity of interleukin-6 and phospholipase C-gamma1. We report two cases of gingival plasma cell granuloma in a 34-yr-old and 40-yr-old two male renal transplant recipients with cyclosporine A (CsA)-induced gingival overgrowth (GO). Histologically, these lesions were composed of mature plasma cells, showing polyclonality for both lambda and kappa light chains and fibrovascular connective tissue stroma. In addition to the fact that CsA-induced plasma cell granuloma is rare, the salient features of our cases were the secretion of interleukin-6 and overexpression of phospholipase C- gamma 1 of the tumor cells, which may explain the mechanisms of CsA- induced GO. ( info) |
136/541. Neuro-Behcet's disease mimicking a cerebral tumor: a case report. We report a rare case of neuro-Behcet's disease (NBD) presenting as an inflammatory pseudotumor in the brain. A 52-year-old woman was evaluated for subacute dizziness and headache. brain magnetic resonance (MR) imaging showed a right cerebellar mass, which disappeared 2 weeks later. After a year, recurrent mucocutaneous manifestations of Beh et's disease were observed. Immunosuppressant and steroid maintenance treatment were started. She experienced two more neurologic attacks and brain MR imaging revealed an enhancing mass in the right temporal lobe. The second attack showed a good response to steroid pulse therapy, but the third attack did not respond to steroid and her neurologic signs suggested an impending transtentorial hernia. The right temporal lobectomy was performed for the purpose of life-saving. The pathologic finding of the mass was a chronic inflammatory vasculitis, compatible with NBD. ( info) |
137/541. Inflammatory pseudotumor (plasma cell granuloma) of the pelvic cavity. A case report. BACKGROUND: Inflammatory pseudotumor (IPT), also called plasma cell granuloma, is a rare, benign, tumorlike lesion composed of proliferating spindle cells admixed with an inflammatory infiltrate and usually affecting the lungs. Other locations can also be affected. CASE: An 18-year-old woman complained of abdominal pain and discomfort. Sonographic evaluation revealed a hyperechogenic mass measuring 32 x 36 mm and located between the right ovary and uterus. CBC showed mild leukocytosis. Laparoscopic resection of the mass revealed histologically an inflammatory pseudotumor. CONCLUSION: IPT may occur at any age and affects both sexes equally. The clinical presentation usually includes fever, leukocytosis and weight loss, although many cases are asymptomatic, especially in the pelvis. The lesion usually presents with distinct borders and a firm consistency and is tan to white. The course of IPT is usually benign and self-limited. Surgical resection is the most common therapy, whereas corticosteroids and, in rare cases, chemotherapy are used. Recurrences have been described. Because of the rarity of this condition, it is unusual for the diagnosis to be made preoperatively. ( info) |
138/541. Pseudomalignant spindle cell proliferation of the urinary bladder: an unusual cause of voiding symptoms in a young patient. A case of an unusually large pseudomalignant spindle-cell proliferation (or inflammatory pseudotumor) of the urinary bladder in a young man is presented. The only symptom was urinary frequency. The clinical and radiologic evaluation (ultrasonography, computed tomography, and magnetic resonance imaging) revealed a massive tumor (11 x 7.5 x 5.5 cm) arising from the bladder wall that was eventually resected without compromising bladder function. Although the histologic findings initially suggested a sarcoma, the immunohistochemical findings were consistent with that of an inflammatory pseudotumor. The patient remained asymptomatic, without evidence of recurrence, after 12 months of follow-up. awareness of this inflammatory pseudotumor and its immunophenotypic characteristics is important to avoid an erroneous diagnosis and unnecessarily aggressive therapy. ( info) |
139/541. Inflammatory myofibroblastic tumor (inflammatory pseudotumor) of the maxillary sinus mimicking malignancy: a case report of an unusual location (is that a true neoplasm?). The inflammatory myofibroblastic tumor (IMT) is a space-occupying lesion of unknown etiology and a distinctive but controversial lesion. This type of tumor is recently considered neoplastic rather than inflammatory. It is usually occurring during childhood, composed of fascicles of bland myofibroblastic cells admixed with a prominent inflammatory infiltrate consisting of lymphocytes, plasma cells, and eosinophils. IMT of the maxilla is very rare. The diagnosis of IMT can be made on the basis of histopathology and immunohistochemistry. Herein, we presented a patient who had IMT of the maxillary sinus that was initially misinterpreted as a malignant neoplasm upon clinical and radiographic examinations. We discussed the diagnostic and therapeutic procedures and may consider it a true neoplasm. ( info) |
140/541. Inflammatory pseudotumor of the lung. Inflammatory pseudotumor is the most frequent primary lung tumor in children under the age of 16. Clinical history and radiological diagnosis are often non-specific, making diagnosis uneasy. In some instances, only surgery can provide a definite diagnosis. However, when dealing with a solitary mass of the lung in an infant the radiologists should always include inflammatory pseudotumor among the entities of the differential diagnosis. This case report discusses the radiological features of inflammatory pseudotumors. ( info) |