title: Inflammatory myofibroblastic tumor appendix with concomitant mucosal dysplasia, simulating pseudomyxoma on preoperative aspiration cytology.
abstract: Inflammatory myofibroblastic tumor (IMT) has been described as a pseudosarcomatous proliferation of spindled myofibroblasts admixed with lymphoplasmacytic cells. The various terminologies like inflammatory pseudotumor, plasma cell granuloma, and inflammatory myofibrohistiocytic proliferation, used to describe this entity, highlight the controversial etiopathogenesis of this relatively indolent neoplasm. IMT has now been described in different anatomic locations. However, cases occurring in the gastrointestinal tract are rare with very few cases described in the appendix. We present a case of inflammatory myofibroblastic tumor appendix with mucosal dysplasia in a 41-year-old male, presenting with abdominal pain and lump in the right iliac fossa. Aspiration cytology yielded few atypical epithelial cells and spindle cells in a mucinous background, suggesting the possibility of pseudomyxoma peritonei. Awareness of IMT appendix with rare presence of mucosal dysplasia may help in preventing overzealous resection, especially in situations that on preoperative evaluation may suggest malignancy.
authors: Department of Pathology, G B Pant Hospital, Jawaharlal Nehru Marg, New Delhi, India.
authors: Kaushik
authors: K
authors: Majumdar
authors: Puja
authors: P
authors: Sakhuja
authors: Sukhpreet
authors: S
authors: Kaur
authors: Archana
authors: A
authors: Rastogi
authors: Ranjana
authors: R
authors: Gondal
authors: Anil
authors: A
authors: Agarwal
mesh_terms: D000199:Actins / Q000378:metabolism; D000328:Adult; D001063:Appendiceal Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D001065:Appendix / Q000473:pathology; D044963:Biopsy, Fine-Needle; D003893:Desmin / Q000378:metabolism; D006104:Granuloma, Plasma Cell / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D057234:Preoperative Period; D011553:Pseudomyxoma Peritonei / Q000175:diagnosis / Q000473:pathology*; D009418:S100 Proteins / Q000378:metabolism; D014463:Ultrasonography
chemical_list: D000199:Actins; D003893:Desmin; D009418:S100 Proteins