Borak Samuel, Siegal Gene P, Reddy Vishnu, Jhala Nirag, Jhala Darshana
Department of Pathology, University of Alabama at Birmingham, AL, USA.
Diagn Cytopathol. 2012 Aug;40 Suppl 2:E118-25. doi: 10.1002/dc.21663. Epub 2011 Apr 6.
Inflammatory myofibroblastic tumor (IMT) is an exquisitely rare neoplasm with a low incidence of metastasis. Previously, cytologic diagnosis of this entity, by fine needle aspiration (FNA) or endoscopic ultrasound guided fine needle aspiration (EUS-FNA), was challenging, if not impossible. However, advancements in the field of molecular pathology, the applications of which have lagged in cytopathology relative to other disciplines, now makes diagnosis possible. Here we report a case of pulmonary inflammatory myofibroblastic tumor with mediastinal nodal metastasis in a 74-year-old man, definitively diagnosed by EUS-FNA utilizing morphologic, immunohistochemical, and molecular findings, including fluorescent in situ hybridization studies for ALK gene rearrangement. This case report demonstrates the value of ancillary molecular studies to assist in the diagnosis of rare neoplasms, including those at sites of metastasis.
炎性肌纤维母细胞瘤（IMT）是一种极为罕见的肿瘤，转移发生率较低。以往，通过细针穿刺抽吸活检（FNA）或内镜超声引导下细针穿刺抽吸活检（EUS-FNA）对该实体进行细胞学诊断即便并非不可能，也是具有挑战性的。然而，分子病理学领域的进展，尽管其在细胞病理学中的应用相对于其他学科滞后，但现在使诊断成为可能。在此，我们报告一例74岁男性的伴有纵隔淋巴结转移的肺部炎性肌纤维母细胞瘤，通过EUS-FNA利用形态学、免疫组织化学和分子学结果，包括针对ALK基因重排的荧光原位杂交研究得以明确诊断。本病例报告展示了辅助分子学研究在协助诊断罕见肿瘤方面的价值，包括那些发生转移部位的肿瘤。
