title: Cutaneous inflammatory myofibroblastic tumours can be anaplastic lymphoma kinase-positive: report of the first four cases.
abstract: OBJECTIVE
  Inflammatory myofibroblastic tumours (IMTs) usually have a soft tissue and visceral localization, but have been rarely reported in skin. The aim of this study was to characterize the histological and immunohistochemical features of a series of cutaneous IMTs.
  
  
  RESULTS
  We retrieved from our archives over 10 years four cutaneous IMTs; one was diagnosed in a child, and three in young adults. Tumours were centred on the dermis, and also involved the subcutis in two cases. Two of them corresponded to the 'myxoid-vascular' pattern of IMT, whereas the others were characterized by compact fascicles of spindle-shaped cells. They stained positively for smooth muscle actin. All samples stained positively for anaplastic lymphoma kinase (ALK). ALK expression was limited to the cytoplasm of myofibroblasts and, in the three investigated cases, correlated with ALK rearrangement as shown by fluorescence in-situ hybridization analysis.
  
  
  CONCLUSIONS
  This is the first report of ALK-positive IMTs with a cutaneous localization. Because of their morphological heterogeneity and low incidence in skin, the diagnosis of cutaneous IMTs is often challenging. A cutaneous spindled cell tumour associated with an inflammatory infiltrate should prompt pathologists to perform ALK staining, which, if positive, might be decisive for diagnosis.
authors.affiliation: Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France.|Université Paul-Sabatier, Toulouse, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Leguellec
authors.affiliation: Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France.|Université Paul-Sabatier, Toulouse, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Tournier
authors.affiliation: Department of Dermatology, Larrey Hospital, CHU de Toulouse, Toulouse, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Karanian
authors.affiliation: Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France.|Université Paul-Sabatier, Toulouse, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Brousset
authors.affiliation: Department of Dermatology, Larrey Hospital, CHU de Toulouse, Toulouse, France.
authors.forename: Juliette
authors.initials: J
authors.lastname: Mazereeuw
authors.affiliation: Department of Biopathology, Institut Bergonié, Bordeaux, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Coindre
authors.affiliation: Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France.|Université Paul-Sabatier, Toulouse, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Lamant
mesh_terms: D000199:Actins / Q000032:analysis; D000328:Adult; D000077548:Anaplastic Lymphoma Kinase; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002648:Child; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D058628:Myofibroblasts / Q000473:pathology; D011505:Protein-Tyrosine Kinases / Q000096:biosynthesis; D020794:Receptor Protein-Tyrosine Kinases / Q000378:metabolism*; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000201:enzymology / Q000473:pathology / Q000601:surgery
chemical_list: D000199:Actins; D014408:Biomarkers, Tumor; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D011505:Protein-Tyrosine Kinases; D020794:Receptor Protein-Tyrosine Kinases
keywords: ALK; FISH analysis; inflammatory myofibroblastic tumour; skin