J Pathol Transl Med.  2017 May;51(3):255-263. 10.4132/jptm.2017.01.12.

Clinicopathological Study of 18 Cases of Inflammatory Myofibroblastic Tumors with Reference to ALK-1 Expression: 5-Year Experience in a Tertiary Care Center

Affiliations
  • 1Department of General Pathology, Christian Medical College and Hospital, Vellore, India. dr.rameshtelugu@gmail.com
  • 2Department of Paediatric Surgery, Christian Medical College and Hospital, Vellore, India.
  • 3Department of Thoracic Surgery, Christian Medical College and Hospital, Vellore, India.

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.

Keyword

ALK protein; Atypia; Prognostic marker; Recurrence; Neoplasms

MeSH Terms

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
Antibodies
Coloring Agents
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