Inflammatory myofibroblastic tumor: an unusual mimicker of childhood intrathoracic tuberculosis.
Inflammatory myofibroblastic tumors are rare lesions of uncertain etiology that are often difficult to diagnose because of their myriad clinical presentations. Not uncommon, they mimic persistent pneumonia. We report a 4-year-old girl who presented with prolonged pyrexia, weight loss, severe anemia, hepatosplenomegaly, and nonresolving pneumonia. Initial investigations including flexible bronchoscopy and bronchial washing for usual causes of persistent pneumonia, such as tuberculosis and other infections, were negative. Chest computed tomography revealed a well-defined lesion involving the lingula and left upper lobe with extension into the subpleural space. Pleural tap and biopsy was also noncontributory. Thoracoscopic biopsy was suggestive of an inflammatory myofibroblastic tumor. As the lesion was encasing the major vessels, it was considered inoperable. The patient did not respond to steroid therapy and etoricoxib and later succumbed to the illness. This uncommon tumor should be considered in the differential diagnosis of children who presented with unresolving consolidation with pyrexia.
Departments of *Pediatrics ‡Radiodiagnosis, Lady Hardinge Medical College †Department of Pediatric Surgery, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi §Department of Pathology, University College of Medical Sciences and Guru Teg Bhadhur Hospital, Delhi, India.
Varinder
V
Singh
Ankit
A
Parakh
Satish K
SK
Aggarwal
Deonath
D
Mahto
Bhavna
B
Dhingra
Anjali
A
Nagpal
Mahender K
MK
Narula
Kiran
K
Mishra
Jagdish
J
Chandra
D001999:Bronchoscopy; D002675:Child, Preschool; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D005334:Fever / Q000175:diagnosis; D006801:Humans; D007249:Inflammation / Q000175:diagnosis*; D009379:Neoplasms, Muscle Tissue / Q000175:diagnosis*; D011014:Pneumonia / Q000175:diagnosis*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*