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Fibrosing inflammatory pseudotumor of the nasopharynx: MR features and histopathologic correlation
So-Young Choi1, In Kyu Yu, Moon Hee Han
1Department of Radiology, Eulji University Hospital, 1306 Dunsan-dong, Seo-gu, Daejeon, South Korea.
Purpose:
To describe the magnetic resonance (MR) imaging features of six cases of pathologically proven fibrosing inflammatory pseudotumor involving the nasopharynx, and to compare the MR signal intensities of the lesions with histopathologic findings.
Methods:
We reviewed the MR finding of six patients with pathologically proved fibrosing inflammatory pseudotumor at the nasopharyngeal wall with respect to the following points: extent, margins, signal intensity and enhancement degree of the lesion; cervical lymphadenopathy and response to steroid therapy. MR findings were correlated with histopathologic findings.
Results:
All lesions showed ill-defined margins and looked less-likely contour bulging features. The signal intensity of the lesions was hypointense or slightly heterogeneous relative to brain cortex on both T1- and T2-weighted images, and enhancement was weakly homogeneous in all cases. There was no demonstrable cervical lymphadenopathy in all cases. After steroid therapy, the lesions showed decreased extent and weaker enhancement in three patients. Histopathologic findings showed high degree of polymorphous inflammatory cellular infiltration with underlying significant reactive fibrosis.
Conclusion:
Fibrotic inflammatory pseudotumors involving nasopharynx are very rare, and can mimic malignancy. MR imaging showed ill-defined margins, hypointensity or slightly heterogenous signal intensity on T2-weighted image and weak enhancement. There was no significant cervical lymphadenopathy.
Insights
Fibrosing inflammatory pseudotumors of the nasopharynx are rare and can mimic cancer. Magnetic resonance (MR) imaging reveals ill-defined margins and characteristic signal intensities, aiding in diagnosis.
Area of Science:
- Radiology
- Pathology
- Oncology
Background:
- Fibrosing inflammatory pseudotumors (FIP) are rare neoplastic mimics.
- Nasopharyngeal FIP can present challenges in diagnosis due to potential malignancy overlap.
Observation:
- Six cases of pathologically proven nasopharyngeal FIP were analyzed.
- Magnetic resonance (MR) imaging features including lesion extent, margins, signal intensity, and enhancement were evaluated.
- Histopathologic findings were correlated with MR imaging characteristics.
Findings:
- MR imaging demonstrated ill-defined margins and less-defined contour bulging in all lesions.
- Lesions exhibited hypointense or slightly heterogeneous signal intensity on T1- and T2-weighted images.
- Weakly homogeneous enhancement was observed, with no significant cervical lymphadenopathy noted.
Implications:
- Nasopharyngeal FIP can mimic malignancy on MR imaging.
- Characteristic MR findings, including ill-defined margins and specific signal intensities, are crucial for differentiation.
- Understanding these imaging features aids in accurate diagnosis and management of rare nasopharyngeal masses.
