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颈部炎性肌纤维母细胞瘤伴甲状腺侵犯:一例报告及文献复习

Inflammatory myofibroblastic tumor of the neck with thyroid invasion: a case report and literature review.

作者信息

Zhao Jinlu, Han Duoji, Gao Meizhuo, Liu Ming, Feng Chulei, Chen Gang, Gu Yue, Jiang Ying

机构信息

Department of General Surgery and Bio-Bank of Department of General Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.

出版信息

Gland Surg. 2020 Aug;9(4):1042-1047. doi: 10.21037/gs-20-355.

Abstract

Inflammatory myofibroblast tumor (IMT) is a unique intermediate soft tissue tumor, comprising myofibroblasts/fibroblasts, with infiltrating plasma cells, lymphocytes, and/or eosinophils. IMT, first reported in 1939 in the lung or pleura, is most common in children or adolescents and in the lungs; however, it can also occur in other tissues. The exact etiology and pathogenesis of IMT are yet to be clarified. Virus-induced trauma, surgery, autoimmune etiology, inflammation, infection, and abnormal responses to long-standing exogenous stimuli in the body, dominated by myofibroblast proliferation, can lead to IMT development. Most patients with IMT have masses, with or without physical manifestations, including fever, weight loss, and various clinical laboratory abnormalities. Surgical resection is the main treatment. IMT is not common in the head and neck region, and additional thyroid involvement is rare. A male patient presented a rapidly growing neck mass was treated and diagnosed with IMT in the neck and thyroid involvement in our hospital in September 2018 by successful surgical resection. Follow-up for 6 months showed no recurrence or metastasis. We review the etiology, clinical features, pathological features, treatment, and prognosis of IMT, with the aim of improving the diagnosis and treatment of this condition in the head and neck region.

摘要

炎性肌成纤维细胞瘤(IMT)是一种独特的中间型软组织肿瘤,由肌成纤维细胞/成纤维细胞组成,并伴有浸润的浆细胞、淋巴细胞和/或嗜酸性粒细胞。IMT于1939年首次在肺或胸膜中被报道,在儿童或青少年以及肺部最为常见;然而,它也可发生于其他组织。IMT的确切病因和发病机制尚待阐明。病毒诱导的创伤、手术、自身免疫病因、炎症、感染以及机体对长期外源性刺激的异常反应,以肌成纤维细胞增殖为主导,可导致IMT的发生。大多数IMT患者有肿块,有或无全身表现,包括发热、体重减轻以及各种临床实验室异常。手术切除是主要治疗方法。IMT在头颈部区域并不常见,且额外累及甲状腺的情况罕见。一名男性患者于2018年9月在我院因颈部肿块迅速增大接受治疗,被诊断为颈部IMT并累及甲状腺,通过成功的手术切除治愈。随访6个月未见复发或转移。我们回顾了IMT的病因、临床特征、病理特征、治疗及预后,旨在提高对头颈部区域该疾病的诊断和治疗水平。

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