Polypoid laryngeal inflammatory myofibroblastic tumors: misleading lesions: description of six cases showing ALK overexpression.
OBJECTIVE
Laryngeal inflammatory myofibroblastic tumors (IMTs) are rarely reported in the literature but may be underrecognized. To better characterize their features, we report a series of six cases.


METHODS
The clinicopathologic findings, including immunohistochemistry, fluorescence in situ hybridization (FISH) analysis, and follow-up, were evaluated and a review of the literature was performed.


RESULTS
These cases presented as small polypoid vocal cord or ventricular band lesions, with a more advanced mean age at diagnosis (49 years) than typically reported in other localizations. Apart from one secondary revision surgery, no complementary treatment and no recurrences were observed. Histologically, various morphologic features were seen. All tumors were spindle cell proliferations on a myxoid background with more or less atypia and significant inflammatory infiltrate. All six cases showed anaplastic lymphoma kinase (ALK) immunohistochemical expression. FISH rearrangement was present in four of six cases. Only two cases were initially diagnosed as IMT.


CONCLUSIONS
According to our series, laryngeal IMTs are easily misdiagnosed. They have a good prognosis, and ALK immunohistochemistry should be carried out to assess this diagnosis when spindle cell proliferations are observed in this localization.
From the Department of Biopathology, Institut Bergonié, Bordeaux, France;
Clémence
C
Pierry
From the Department of Biopathology, Institut Bergonié, Bordeaux, France;
Gaëlle
G
Pérot
From the Department of Biopathology, Institut Bergonié, Bordeaux, France; Université Bordeaux, Bordeaux, France;
Marie
M
Karanian-Philippe
From the Department of Biopathology, Institut Bergonié, Bordeaux, France; Université Bordeaux, Bordeaux, France;
Agnès
A
Neuville
Department of Pathology, Rangueil University Hospital, Toulouse, France; and.
Anne
A
Gomez-Brouchet
ENT and Maxillofacial Surgery Department, Larrey University Hospital, Toulouse, France.
Sabine
S
Crestani
From the Department of Biopathology, Institut Bergonié, Bordeaux, France; Université Bordeaux, Bordeaux, France; j.coindre@bordeaux.unicancer.fr.
Jean-Michel
JM
Coindre
D000328:Adult; D000369:Aged, 80 and over; D000077548:Anaplastic Lymphoma Kinase; D014408:Biomarkers, Tumor / Q000378:metabolism*; D003951:Diagnostic Errors / Q000517:prevention & control; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D017404:In Situ Hybridization, Fluorescence / Q000379:methods; D007822:Laryngeal Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009379:Neoplasms, Muscle Tissue / Q000175:diagnosis* / Q000378:metabolism*; D020794:Receptor Protein-Tyrosine Kinases / Q000378:metabolism*
D014408:Biomarkers, Tumor; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases
ALK; Anaplastic lymphoma kinase; Inflammatory myofibroblastic tumor; Laryngeal tumor; Vocal cord polyp