Abu-Salah Asma Khalid, Brocken Eric, Mesa Hector, Collins Katrina
Department of Pathology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Case Rep Pathol. 2023 Apr 13;2023:9417141. doi: 10.1155/2023/9417141. eCollection 2023.
Inflammatory fibroid polyp (IFP), initially considered a reactive process, is now recognized as a benign mesenchymal neoplasm of the gastrointestinal tract. We report a case of a 68-year-old woman with medically refractory Crohn disease that presented with intussusception requiring surgical intervention. The resection revealed a jejunal mass consisting of a submucosal proliferation of bland spindle cells in a fibrous stroma infiltrated by numerous eosinophils. By immunohistochemistry, the lesion was positive for vimentin and negative for desmin, smooth muscle actin (SMA), S-100, CD117, DOG1, ALK (D5F3), Melan-A, HMB-45, CD34, and STAT6. Ki-67 proliferative index was low (<1%). The mass was classified as IFP by its characteristic morphology and associated eosinophilia. IFP should be considered in the differential diagnosis of adults with intussusception or bowel obstruction. Definitive treatment typically requires surgical resection of the involved bowel segment.
炎症性纤维瘤性息肉(IFP)最初被认为是一种反应性过程,现在被公认为是胃肠道的一种良性间叶性肿瘤。我们报告一例68岁患有药物难治性克罗恩病的女性病例,该患者因肠套叠需要手术干预。切除标本显示空肠肿物,由纤维性间质中温和的梭形细胞黏膜下增生构成,间质中有大量嗜酸性粒细胞浸润。免疫组织化学检查显示,该病变波形蛋白阳性,结蛋白、平滑肌肌动蛋白(SMA)、S-100、CD117、DOG1、间变性淋巴瘤激酶(ALK,D5F3)、黑素A、HMB-45、CD34和信号转导子和转录激活子6(STAT6)均为阴性。Ki-67增殖指数较低(<1%)。根据其特征性形态和相关嗜酸性粒细胞增多,该肿物被分类为IFP。对于成人肠套叠或肠梗阻的鉴别诊断应考虑IFP。明确的治疗通常需要手术切除受累肠段。