Key Laboratory of Women and Children Diseases, department of pediatrics, West China Second University Hospital, Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Sichuan University, Ministry of Education, Chengdu, 610041, China.
BMC Pediatr. 2023 Nov 24;23(1):597. doi: 10.1186/s12887-023-04431-1.
Symptoms of inflammatory myofibroblastic tumor (IMT) are atypical, and histopathological misdiagnosis of IMT is still inevitable. Here we present a pediatric case that an eight-year-old boy with recurrent fever for fifteen months, received anti-tuberculosis therapy for five months and was ultimately confirmed to be IMT.
An eight-year-old boy experienced a recurrent fever for fifteen months, accompanied by cough, vomiting, meteorism, night sweating, and emaciation. Thoracoabdominal computer tomography revealed multiple enlarged lymph nodes in the thorax, abdomen, and axilla, as well as minimal bilateral pleural effusion. Histopathological examinations of the intestines and greater omentum implied fibrous tissue hyperplasia along with eosinophil and lymphocyte infiltration. The patient was initially misdiagnosed with tuberculosis, and symptoms were relieved partially following anti-tuberculosis treatment. However, after four months, the symptoms aggravated again and a subsequent histopathological analysis of a second sample from the greater omentum revealed the presence of IMT. Eventually, after surgical resection of the lesions and chemotherapy, the clinical symptoms in the child gradually alleviated.
The clinical course of IMT is variable, and pediatricians should pay attention to differentiating IMT from tuberculosis.
炎性肌纤维母细胞瘤（IMT）的症状不典型，组织病理学误诊 IMT 仍然不可避免。我们在此报告一例儿科病例，一名 8 岁男孩反复发热 15 个月，接受抗结核治疗 5 个月，最终确诊为 IMT。
一名 8 岁男孩反复发热 15 个月，伴有咳嗽、呕吐、腹胀、夜间出汗和消瘦。胸腹计算机断层扫描显示胸部、腹部和腋窝有多个增大的淋巴结，以及双侧少量胸腔积液。肠道和大网膜的组织病理学检查提示纤维组织增生，伴有嗜酸性粒细胞和淋巴细胞浸润。该患者最初被误诊为肺结核，抗结核治疗后部分症状缓解。然而，四个月后，症状再次加重，随后对大网膜的第二个样本进行组织病理学分析显示存在 IMT。最终，通过手术切除病变和化疗，患儿的临床症状逐渐缓解。
IMT 的临床病程多变，儿科医生应注意将 IMT 与肺结核相鉴别。
