Laryngeal inflammatory myofibroblastic tumors: Different clinical appearance and histomorphologic presentation of one entity.
BACKGROUND
Inflammatory myofibroblastic tumors (IMFTs) of the larynx are rare. We report the clinical presentation, histomorphology, and new molecular findings of 2 cases.


METHODS
Paraffin-embedded specimens were stained immunohistochemically (eg, vimentin, AE1/3, Alk-1, smooth muscle [sm-]actin, p53, Rb1, immunoglobulin G4 [IgG4]). Epstein-Barr virus-encoded RNA (EBER) in situ hybridization and HHV8-polymerase chain reaction (PCR) were done. Comparative genomic hybridization (CGH) was performed.


RESULTS
Case 1 was that of a 56-year-old man with an infiltrating plasma-cell-rich tumor (Alk-1-, sm-actin+). Plasma cells were strongly positive for IgG4. CGH was unsuspicious. Case 2 was that of a 34-year-old woman with an exophytic tumor (Alk-1+). CGH revealed losses on 13q14-22. The few plasma cells were negative for IgG4. The proliferation (Ki67) was low in both cases.


CONCLUSIONS
Different types of IMFTs may exist and could indicate different therapeutic strategies. Alk-1-positive cases with only scattered inflammatory cells could represent the neoplastic variant, whereas cases rich in plasma cells could be associated with IgG4 sclerosing diseases.
Völker
Hans-Ullrich
HU
Institute of Pathology, University Würzburg, Würzburg, Germany. ullrich.voelker@mail.uni-wuerzburg.de
Scheich
Matthias
M
Zettl
Andreas
A
Hagen
Rudolf
R
Müller-Hermelink
Hans Konrad
HK
Gattenlöhner
Stefan
S
D030301:Activin Receptors, Type II / Q000378:metabolism; D000328:Adult; D019002:CD56 Antigen / Q000378:metabolism; D002872:Chromosome Deletion; D002882:Chromosomes, Human, Pair 13 / Q000235:genetics; D055028:Comparative Genomic Hybridization; D005260:Female; D006104:Granuloma, Plasma Cell / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D019394:Ki-67 Antigen / Q000378:metabolism; D007818:Laryngeal Diseases / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D010950:Plasma Cells / Q000276:immunology; D009418:S100 Proteins / Q000378:metabolism
D019002:CD56 Antigen; D007074:Immunoglobulin G; D019394:Ki-67 Antigen; C522918:NCAM1 protein, human; D009418:S100 Proteins; C425364:ACVRL1 protein, human; D030301:Activin Receptors, Type II