THE IMPORTANCE OF MORPHOLOGICAL MARKERS IN DIFFERENTIAL DIAGNOSTICS OF SPLEEN INFLAMMATORY MYOFIBROBLASTIC PSEUDOTUMOUR

DOI: https://doi.org/10.29296/24999490-2019-01-04

Yu.A. Stepanova, D.A. Ionkin, D.V. Kalinin, A.V. Glotov, M.Z. Alimurzaeva A.V. Vishnevsky National Medical Research Center of Surgery, B. Serpukhovskaya Str., 27, Moscow, 117997, Russian Federation Е-mail: stepanovaua@mail.ru

Introduction. Inflammatory myofibroblastic neoplasm (IMN) of the spleen is extremely rare. It is often benign lesion, represented mainly by fusiform myofibroblasts and inflammatory cells (plasma, lymphocytes and eosinophilic granulocytes). Clinically, the spleen IMN can be both symptomatic and asymptomatic. There are no definite clinical and/or radiological signs of the IMN, which, as a result of the preoperative stage, is not diagnosed. In the diagnosis and treatment of IMN, the possibility of malignant tumor degeneration should be taken into account. Therefore, a surgical approach is advisable to confirm the diagnosis and exclude malignancy during histological examination. Method. Clinical observation of a 34-year-old patient with spleen IMN is presented (informed consent of the patient to the possibility of publishing data was obtained). The difficulties in the diagnosis of this lesion and the possibilities of surgical treatment are shown. Establishing diagnosis was possible only according to histological and immunohistochemical studies. Results. Microscopically, the tumor is represented by granulation tissue of various degrees of maturity with the presence of fibroblasts, histiocytes, plasma cells, and collagen bundles. Often there are macrophages, neutrophilic and eosinophilic granulocytes. Conclusion. A characteristic feature is pronounced vascularization of the lesion. An immunohistochemical study revealed a positive reaction for vimentin and SMA, negative for CD34, CD117, S-100, and MyoD1.
Keywords: 
an inflammatory myofibroblastic tumor of a spleen, radiological diagnosis, diagnosis verification, immunohistochemistry, surgical treatment

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