Institute of Pathology, University Würzburg, Würzburg, Germany.
Head Neck. 2010 Nov;32(11):1573-8. doi: 10.1002/hed.21232.
Inflammatory myofibroblastic tumors (IMFTs) of the larynx are rare. We report the clinical presentation, histomorphology, and new molecular findings of 2 cases.
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.
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.
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.
喉部炎性肌纤维母细胞瘤（IMFT）较为罕见。我们报告了 2 例病例的临床表现、组织形态学和新的分子发现。
石蜡包埋标本行免疫组织化学染色（例如，波形蛋白、AE1/3、ALK-1、平滑肌肌动蛋白、p53、Rb1、免疫球蛋白 G4）。进行 EBV 编码 RNA（EBER）原位杂交和 HHV8-聚合酶链反应（PCR）。进行比较基因组杂交（CGH）。
病例 1 为 56 岁男性，浸润性富含浆细胞的肿瘤（ALK-1-，sm-肌动蛋白+）。浆细胞 IgG4 染色阳性。CGH 无异常。病例 2 为 34 岁女性，外生性肿瘤（ALK-1+）。CGH 显示 13q14-22 缺失。少数浆细胞 IgG4 染色阴性。两种情况下增殖（Ki67）均较低。
可能存在不同类型的 IMFT，这可能提示不同的治疗策略。仅存在散在炎症细胞的ALK-1 阳性病例可能代表肿瘤性变体，而富含浆细胞的病例可能与 IgG4 硬化性疾病相关。
