CONTEXT: Inflammatory myofibroblastic tumor is a predominantly benign, spindle cell, mesenchymal neoplasm with myxoid areas that occurs rarely in the female genital tract and may be confused with other spindle cell lesions, particularly leiomyosarcoma. OBJECTIVE: To investigate the utility of detecting anaplastic lymphoma kinase-1 protein expression and ALK gene rearrangements in the diagnosis of inflammatory myofibroblastic tumors in the female genital tract. DESIGN: Eight inflammatory myofibroblastic tumors arising in the female genital tract and seen in consultation (from 2004 to 2011) were reviewed. Immunohistochemistry for anaplastic lymphoma kinase-1 and fluorescence in-situ hybridization studies for ALK gene rearrangements were performed. RESULTS: The anatomic sites included myometrium (4 cases) and endometrium, fallopian tube, cervix, and a cervical polyp (1 each), with a patient age range from 25 to 52 years. Histologic features ranged from bland spindle cells to striking cytologic atypia, embedded in a prominent myxoid background. Anaplastic lymphoma kinase-1 immunohistochemistry was positive in 7 cases. Fluorescence in-situ hybridization studies detected ALK gene rearrangements in 5 cases. Five cases had both immunopositivity and fluorescence in-situ hybridization abnormalities, 2 cases had immunopositivity only, and 1 case was negative by both methods. CONCLUSIONS: This is the first report, to our knowledge, of ALK gene rearrangements in inflammatory myofibroblastic tumors in the female genital tract. If a myxoid background is appreciated in a spindle cell lesion of the female genital tract, especially if inflammatory cells are present, anaplastic lymphoma kinase-1 staining along with fluorescence in situ hybridization studies, for ALK gene rearrangements, may aid in distinguishing inflammatory myofibroblastic tumors from their malignant mimics.
CONTEXT: Inflammatory myofibroblastic tumor is a predominantly benign, spindle cell, mesenchymal neoplasm with myxoid areas that occurs rarely in the female genital tract and may be confused with other spindle cell lesions, particularly leiomyosarcoma. OBJECTIVE: To investigate the utility of detecting anaplastic lymphoma kinase-1 protein expression and ALK gene rearrangements in the diagnosis of inflammatory myofibroblastic tumors in the female genital tract. DESIGN: Eight inflammatory myofibroblastic tumors arising in the female genital tract and seen in consultation (from 2004 to 2011) were reviewed. Immunohistochemistry for anaplastic lymphoma kinase-1 and fluorescence in-situ hybridization studies for ALK gene rearrangements were performed. RESULTS: The anatomic sites included myometrium (4 cases) and endometrium, fallopian tube, cervix, and a cervical polyp (1 each), with a patient age range from 25 to 52 years. Histologic features ranged from bland spindle cells to striking cytologic atypia, embedded in a prominent myxoid background. Anaplastic lymphoma kinase-1 immunohistochemistry was positive in 7 cases. Fluorescence in-situ hybridization studies detected ALK gene rearrangements in 5 cases. Five cases had both immunopositivity and fluorescence in-situ hybridization abnormalities, 2 cases had immunopositivity only, and 1 case was negative by both methods. CONCLUSIONS: This is the first report, to our knowledge, of ALK gene rearrangements in inflammatory myofibroblastic tumors in the female genital tract. If a myxoid background is appreciated in a spindle cell lesion of the female genital tract, especially if inflammatory cells are present, anaplastic lymphoma kinase-1 staining along with fluorescence in situ hybridization studies, for ALK gene rearrangements, may aid in distinguishing inflammatory myofibroblastic tumors from their malignant mimics.
Authors: Jennifer A Bennett; Valentina Nardi; Marjan Rouzbahman; Vicente Morales-Oyarvide; G Petur Nielsen; Esther Oliva Journal: Mod Pathol Date: 2017-06-30 Impact factor: 7.842
Authors: Natasha Lewis; Robert A Soslow; Deborah F Delair; Kay J Park; Rajmohan Murali; Travis J Hollmann; Ben Davidson; Francesca Micci; Ioannis Panagopoulos; Lien N Hoang; Javier A Arias-Stella; Esther Oliva; Robert H Young; Martee L Hensley; Mario M Leitao; Meera Hameed; Ryma Benayed; Marc Ladanyi; Denise Frosina; Achim A Jungbluth; Cristina R Antonescu; Sarah Chiang Journal: Mod Pathol Date: 2017-12-01 Impact factor: 7.842
Authors: Vivek Subbiah; Caitlin McMahon; Shreyaskumar Patel; Ralph Zinner; Elvio G Silva; Julia A Elvin; Ishwaria M Subbiah; Chimela Ohaji; Dhakshina Moorthy Ganeshan; Deepa Anand; Charles F Levenback; Jenny Berry; Tim Brennan; Juliann Chmielecki; Zachary R Chalmers; John Mayfield; Vincent A Miller; Philip J Stephens; Jeffrey S Ross; Siraj M Ali Journal: J Hematol Oncol Date: 2015-06-11 Impact factor: 17.388
Authors: Vincenzo Dario Mandato; Riccardo Valli; Valentina Mastrofilippo; Alessandra Bisagni; Lorenzo Aguzzoli; Giovanni Battista La Sala Journal: Medicine (Baltimore) Date: 2017-12 Impact factor: 1.817