Clinicopathological Study of 18 Cases of Inflammatory Myofibroblastic Tumors with Reference to ALK-1 Expression: 5-Year Experience in a Tertiary Care Center.
- Author:
Ramesh Babu TELUGU
1
;
Anne Jennifer PRABHU
;
Nobin Babu KALAPPURAYIL
;
John MATHAI
;
Birla Roy GNANAMUTHU
;
Marie Therese MANIPADAM
Author Information
- Publication Type:Original Article
- Keywords: ALK protein; Atypia; Prognostic marker; Recurrence; Neoplasms
- MeSH: Antibodies; Child; Classification; Coloring Agents; Cytogenetics; Humans; Immunohistochemistry; Liver; Lung; Lymphoma; Myofibroblasts*; Neoplasm Metastasis; Pelvic Bones; Recurrence; Retrospective Studies; Tertiary Care Centers*; Tertiary Healthcare*; World Health Organization; Young Adult
- From:Journal of Pathology and Translational Medicine 2017;51(3):255-263
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Inflammatory myofibroblastic tumor is a histopathologically distinctive neoplasm of children and young adults. According to World Health Organization (WHO) classification, inflammatory myofibroblastic tumor is an intermediate-grade tumor, with potential for recurrence and rare metastasis. There are no definite histopathologic, molecular, or cytogenetic features to predict malignant transformation, recurrence, or metastasis. METHODS: A 5-year retrospective study of histopathologically diagnosed inflammatory myofibroblastic tumors of various anatomic sites was conducted to correlate anaplastic lymphoma kinase-1 (ALK-1) expression with histological atypia, multicentric origin of tumor, recurrence, and metastasis. Clinical details of all the cases were noted from the clinical work station. Immunohistochemical stains for ALK-1 and other antibodies were performed. Statistical analysis was done using Fisher exact test. RESULTS: A total of 18 cases of inflammatory myofibroblastic tumors were found during the study period, of which 14 were classical. The female-male ratio was 1:1 and the mean age was 23.8 years. Histologically atypical (four cases) and multifocal tumors (three cases, multicentric in origin) were noted. Recurrence was noted in 30% of ALK-1 positive and 37.5% of ALK-1 negative cases, whereas metastasis to the lung, liver, and pelvic bone was noted in the ALK-1 positive group only. CONCLUSIONS: Overall, ALK-1 protein was expressed in 55.6% of inflammatory myofibroblastic tumors. There was no statistically significant correlation between ALK-1 expression, tumor type, recurrence and metastasis. However, ALK-1 immunohistochemistry is a useful diagnostic aid in the appropriate clinical and histomorphologic context.
