Multidetector Computed Tomography Imaging Features of Inflammatory Myofibroblastic Tumors of the Gastrointestinal Tract in Adults: Radiological, Histopathological, and Immunohistochemical Features

AuthorIn Young Choien
AuthorSuk Keu Yeomen
AuthorBeom Jin Parken
AuthorDeuk Jae Sungen
AuthorMin Ju Kimen
AuthorNa Yeon Hanen
AuthorYang Shin Parken
AuthorSang Hoon Chaen
AuthorSo Yeon Kimen
AuthorJung-Woo Choien
OrcidSuk Keu Yeom [0000-0002-3390-9793]en
OrcidDeuk Jae Sung [0000-0002-5025-3052]en
OrcidMin Ju Kim [0000-0003-0979-9835]en
OrcidNa Yeon Han [0000-0001-8537-8165]en
OrcidSo Yeon Kim [0000-0001-6853-8577]en
Issued Date2023-01-31en
AbstractBackground: Inflammatory myofibroblastic tumors (IMTs) of the gastrointestinal (GI) tract are rare phenomena, and the computed tomography (CT) findings of GI IMTs are not well-established. Objectives: To describe the characteristics of CT scans, pathological specimens, and histological subtypes of GI IMTs in adults. Patients and Methods: The multidetector computed tomography (MDCT) scans of 11 adult patients (8 males, 3 females; age range, 19 - 76 years) with pathologically proven GI tract IMTs (stomach, small bowel, and colon) were retrospectively evaluated by two abdominal radiologists. The radiological features of IMTs were investigated. The imaging features were correlated with three microscopic IMT subtypes (myxoid vascular, spindle cell, and hypocellular fibrous). Immunohistochemistry was also performed on the specimens, including smooth muscle actin (SMA), vimentin, desmin, S-100, and anaplastic lymphoma kinase. Results: The tumor size ranged from 1.4 to 15 cm (mean, 5.7 cm). Two growth patterns were classified, namely, wall-thickening (n = 3) and solitary mass-forming (n = 8) patterns; each pattern was matched with a characteristic pathological subtype. All solitary, well-circumscribed masses corresponded to the spindle cell type. Low-attenuation wall thickening with perienteric infiltration was observed in three patients with a wall-thickening pattern. All solitary, well-circumscribed masses (n = 8) showed homogeneous enhancement with variable internal low attenuation, correlated with cystic degeneration, necrosis, myxoid change (n = 6), and hemorrhagic necrosis (n = 2). No patient showed bowel obstruction, while one patient showed regional lymphadenopathy. Immunophenotypes were not correlated with any growth pattern or histological subtype. Conclusion: The GI IMTs can be classified into two patterns, including wall-thickening and well-circumscribed masses, each matched with a characteristic pathological subtype, which can help explain the tumor behavior. Concomitant CT findings may also provide diagnostic clues for IMT.en
DOIhttps://doi.org/10.5812/iranjradiol-129661en
KeywordStomachen
KeywordIntestinesen
KeywordMultidetector Computed Tomographyen
KeywordNeoplasmsen
KeywordGranulomaen
PublisherBrieflandsen
TitleMultidetector Computed Tomography Imaging Features of Inflammatory Myofibroblastic Tumors of the Gastrointestinal Tract in Adults: Radiological, Histopathological, and Immunohistochemical Featuresen
TypeResearch Articleen

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