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Computed tomography appearance of inflammatory myofibroblastic tumor in the abdomen: CT features and pathologic
Bo Liu1, Junlong Xu2, Jiaxin Wang3
1Department of X-Ray, Chinese Medicine Hospital of Henan Province Zhengzhou 450002, China.
Insights
This study identified two distinct CT patterns for abdominal inflammatory myofibroblastic tumors (IMTs). These patterns correlate with histopathology but cannot solely differentiate IMTs from other lesions.
Area of Science:
- Radiology
- Pathology
- Oncology
Background:
- Abdominal inflammatory myofibroblastic tumors (IMTs) are rare neoplasms with diverse presentations.
- Accurate preoperative diagnosis of IMTs is challenging due to overlapping imaging features with other abdominal masses.
Observation:
- This study retrospectively analyzed CT findings and histopathology of ten intra-abdominal IMTs.
- Radiologists evaluated imaging features, correlating them with confirmed histopathological characteristics.
Findings:
- Two main CT patterns were identified: Type 1 (distinct boundary, hypo-enhancement) correlated with myxoid/hypocellular fibrous IMTs.
- Type 2 (indistinct boundary, heterogeneous/circumferential enhancement) correlated with abundant micromodules and inflammatory cell infiltration.
- Heterogeneity and contrast enhancement were common to all IMTs.
Implications:
- Identifying these CT patterns aids in understanding the relationship between IMT morphology and histopathology.
- CT appearance alone is insufficient for definitive IMT diagnosis.
- Combining CT imaging with diagnostic biopsy is crucial for accurate diagnosis and treatment planning.
Objective:
To evaluate CT findings of abdominal inflammatory myofibroblastic tumor (IMT) and the relationship with morphological character.
Materials And Methods:
CT examinations and pathological findings of ten intra-abdominal IMTs were retrospectively analyzed. The histopathological characteristics of the IMTs were confirmed by two pathologists and two radiologists evaluated CT findings of the lesion, with emphasis on the imaging features compared with the corresponding histopathology.
Results:
The most common imaging characteristics were presence of heterogeneity, all tumors showed varying degrees of contrast enhancement. Two major different CT patterns were individualized. In type one, the tumor had a distinct boundary without a lobular appearance and displayed hypo-enhanced enhancement after administration of contrast in correlated with the mainly histopathologic findings of spindle cells myxoid and hypocellular fibrous (6/10; 60%). In type two, the lesions exhibited indistinct boundaries or complete capsule, ill-defined growth patterns or low intralesional attenuation with marked heterogeneous or circumferential enhancement, which correlated well with the presence of abundance of micromodule and inflammatory cell infiltration (4/10; 40%).
Conclusions:
Two major different contrast enhancement CT patterns were individualized can help to determine the relationships with histopathologic findings, while cannot be reliably differentiated from other solid lesions based solely on the CT appearance, combined with diagnostic biopsy may facilitate to achieve a correct diagnosis and treatment.
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