Inflammatory Myofibroblastic Tumor of the Pancreas: Immunohistochemical Analysis of a Case and Review of the Literature
Hirozumi Sawai, Yuji Okada, Hitoshi Funahashi, Yoichi Matsuo, Hiroki Takahashi, Hiromitsu Takeyama, Tadao Manabe
CaseRepClinPractRev 2005; 6:354-359
Background: The aim of this study is to investigate the clinicopathological characteristics of inflammatory myofibroblastic tumor (IMT) of the pancreas.
Case Report: We present herein a case of IMT of the pancreas in a 51-year-old man with immunohistochemical
analysis and a review of the IMT in the English literature. A 51-year-old Japanese man was
diagnosed as carcinoma of the pancreatic head and he underwent a pylorus-ring preserving
pancreatoduodenectomy. The pathological diagnosis was IMT. The immunohistochemical examination revealed that although the p53 protein test was negative, tests for alpha-smooth muscle actin, desmin, and vimentin were positive in spindle cells. A majority of spindle cells in this tumor also stained for neuron specific enolase and S-100 protein. Strong positive immunostaining for the α[sub]6[/sub]- and β[sub]1[/sub]-integrin subunits, interleukin-1 receptor type I, the nuclear factor-kappaB p65 subunit and proliferating cell nuclear antigen was found in a majority of the spindle cells. These immunohistochemical results suggested the possibility that the IMT in this patient had a malignant.
Conclusions: This case gave us some difficulty, and the correct diagnosis of the pancreatic tumor was valuable. To diagnose the malignant potential of this type of tumor accurately may have value to direct
the appropriate therapeutic operations after surgery and postoperative progress observation.
Keywords: inflammatory myofibroblastic tumor, Pancreatic Neoplasms, Integrins, interleukin-1 receptor type I, Immunohistochemistry