Inflammatory pseudotumour of lymph node and spleen

Epidemiology

Inflammatory pseudotumour is thought to be a self-limiting reactive condition. Viruses, particularly EBV2 and human herpes virus-8, have been implicated in the pathogenesis.

Clinical features

Inflammatory pseudotumour occurs across a wide age range. It is a rare cause of lymphadenopathy. Clinical features include weight loss, fever, fatigue, raised ESR and anaemia.

Histopathology

There is an admixture of bland spindle cells, myofibroblastic and/or histiocytic with a polymorphic inflammatory cell infiltrate, including lymphocytes, plasma cells and occasional granulocytes.

Immunohistochemistry

ALK-1

0/131, 0/102, 0/43

 

HHV8

0/131

CD68

6/81

SMA

5/61

Desmin

negative1

S-100

negative1

CD2

lymphocytes positive1

CD3

lymphocytes positive1

CD5

lymphocytes positive1

CD19

only lymphocytes in residual follicles positive1

CD20

only lymphocytes in residual follicles positive1

CD21

negative1

CD30

some immunoblasts positive1

CD35

negative1

CD43

lymphocytes positive1

CD45RO

lymphocytes positive1

light chain

polytypic1

Pan-cytokeratin, MNF-116

negative1

HMB-45

negative1

 

 

Differential diagnosis

References

1Kutok, J. L., Pinkus, G. S., Dorfman, D. M., Fletcher, C. D. Inflammatory pseudotumor of lymph node and spleen: an entity biologically distinct from inflammatory myofibroblastic tumor. Human Pathol 2001;32:1382-1387.

2Neuhauser, T. S., Derringer, G. A., Thompson, L. D., Fanburg-Smith, J. C., Aguilera, N. S., Andriko, J., Chu, W., Abbondanzo, S. L. Splenic inflammatory myofibroblastic tumor (inflammatory pseudotumor): a clinicopathologic and immunophenotypic study of 12 cases. Arch Pathol Lab Med 2001;125:379-385.

3Cook, J. R., Dehner, L. P., Collins, M. H., Ma, Z., Morris, S. W., Coffin, C. M., Hill, D. A. Anaplastic lymphoma kinase (ALK) expression in the inflammatory myofibroblastic tumor: a comparative immunohistochemical study. Am J Surg Pathol 2001;25:1364-1371.

 

This page last revised 7.5.2002.

©SMUHT/PW Bishop