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Collegium antropologicum, Vol. 36 supplement 2 No. 2, 2012.

Short communication, Note

Inflammatory Pseudotumor Presenting as a Facial Swelling

Emil Dediol ; University of Zagreb, Dubrava University Hospital, Department of Maxillofacial Surgery, Zagreb, Croatia
Spomenka Manojlović ; University of Zagreb, Dubrava University Hospital, Department of Pathology, Zagreb, Croatia
Čedna Tomasović Lončarić ; University of Zagreb, Dubrava University Hospital, Department of Pathology, Zagreb, Croatia
Josip Biočić ; University of Zagreb, Dubrava University Hospital, Department of Maxillofacial Surgery, Zagreb, Croatia
Josip Hat ; University of Zagreb, Dubrava University Hospital, Department of Radiology, Policlinic Medikol, Zagreb, Croatia

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Abstract

We present a case of inflammatory pseudotumor (IPT) presenting as a facial swelling after an accidental hit on a right side of a face. As swelling did not resolve, dental examination and teeth extraction were done by a dentist presuming the swelling was misdiagnosed with infection of dental origin. Swelling grew even bigger and patient was referred to Department of Maxillofacial Surgery. CT scan of the face and FNA of the lesion was ordered. A homogenous tumor mass
in the right infraorbital region in front of anterior wall of the maxillary sinus was seen on CT. The result of the FNA was reactive hyperplasia of the lymph node. Since the lesion was easily accessible surgical exploration and complete extirpation was done. Pathohistological analysis indicated a low grade B-cell Non Hodgkin lymphoma. PCR showed policlonality of B cells discarding the diagnosis of lymphoma. Pathohistological review showed diffuse intramuscular, perineural
and perivascular infiltration with small lymphocytes without formation of germinative centers. Imunohistochemistry was positive for CD20 and CD3. Taking into account all features the diagnosis of IPT was established. Diagnosis of IPT is a diagnosis by exclusion, combining clinical, radiological and pathohistological characteristics. Lack of clear histologic criteria makes differential diagnosis extremely difficult. Our case is unique regarding localisation of head & neck
IPT, no case presenting on the face in infraorbital region has been described in the literature. Although IPT is very rare in general and especially on the face, one should be aware of it when considering differential diagnosis of facial swelling.

Keywords

inflammatory pseudotumor; plasma cell granuloma; inflammatory miofibroblastic pseudotumor; face; head & neck

Hrčak ID:

96490

URI

https://hrcak.srce.hr/96490

Publication date:

2.1.2013.

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