title: Inflammatory myofibroblastic tumor of the central nervous system: clinicopathologic analysis of 10 cases.
abstract: To verify the pathologic features, anaplastic lymphoma kinase (ALK) expression and biologic behavior of inflammatory myofibroblastic tumors (IMTs) of the central nervous system (CNS), we analyzed 10 cases of IMTs-CNS (8 cranial, 1 spinal, and 1 orbital). Our series of IMTs of the CNS showed a male predominance (male:female = 6:4) and a wide age range (10-60 years; mean age, 46.7 years). Lesion location also varied, but they were basically dura-based. Radiologically, they showed two patterns: isolated mass forming (n = 6) and an en plaque-like pattern (n = 4). Histopathologically, plasma cell granuloma (PCG)-like (n = 5) or fibrohistiocytic (FHC) variant (n = 5) was present. No correlation was found between the radiologic and histopathologic patterns. Spindle-shaped mesenchymal cells of IMTs expressed smooth muscle actin (SMA) in all cases. ALK expression was not found in our IMTs of the CNS. Late recurrence was found in 2 cases in different sites (20%). Pathologically, IMT-CNS could be subclassified into PCG-like and FHC. Immunostaining for SMA was found to helpfully discriminate myofibroblastic cells and to make a differential diagnosis. Although our cases did not show ALK immunoreactivity, some IMTs-CNS can recur, which suggests the neoplastic potential of these tumors. The rearrangement of the ALK gene in IMTs-CNS should be verified by an examination of more cases.
authors.affiliation: Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yoon Kyung
authors.initials: YK
authors.lastname: Jeon
authors.forename: Kee-Hyun
authors.initials: KH
authors.lastname: Chang
authors.forename: Yeon-Lim
authors.initials: YL
authors.lastname: Suh
authors.forename: Hee Won
authors.initials: HW
authors.lastname: Jung
authors.forename: Sung-Hye
authors.initials: SH
authors.lastname: Park
mesh_terms: D000199:Actins / Q000378:metabolism; D000328:Adult; D000368:Aged; D016543:Central Nervous System Neoplasms / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006104:Granuloma, Plasma Cell / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007249:Inflammation / Q000209:etiology / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009379:Neoplasms, Muscle Tissue / Q000150:complications* / Q000378:metabolism / Q000473:pathology*; D012737:Sex Factors; D013194:Staining and Labeling / Q000379:methods
chemical_list: D000199:Actins