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Inflammatory pseudotumor of the cervix: a case report and review of the literature
Irena Novosel
; Department of Pathology, Dr. Ivo Pedišić General Hospital, Sisak, Croatia
Damir Babić
; Department of Gynecological and Perinatal Pathology, University Hospital Center, Zagreb, Croatia
Jadranka Ilić
; Department of Gynecological and Perinatal Pathology, University Hospital Center, Zagreb, Croatia
Abstract
The third recorded case of an inflammatory pseudotumor (IPT) of the cervix is reported.
IPT is considered to be a benign, self-limited lesion of obscure etiology. The condition is thought to be related to an unusual tissue response to injury, past fungal or bacterial infection and autoimmune disorders.
In December 2003, an 18-year-old nulliparous woman presented in our hospital with dysfunctional bleeding. An incidental finding of a solitary leiomyoma-like mass, measuring 4.2 by 3.8 cm, originating from the cervix, was detected by gynecological examination. The tumor was surgically excised. Samples were stained by H&E, Gomori, pan-cytokeratin, vimentin, SMA, myoglobin, desmin, s-100, CD-68, Factor VIII and p53.
Microscopic evaluation of H/E samples showed a distinctive mesenchymal lesion composed of spindle cells displaying morphological features of myofibroblasts, fibroblasts and histiocytes mixed with a considerable number of inflammatory cells. Immunohistochemical analysis showed a positive reaction to vimentin, SMA, myoglobin, CD-68, and some tumor cells were unexpectedly positive to s-100. Gomori and Factor VIII emphasized the reticulin/capillary network.
Although extremely rare in this site, IPT should be taken into consideration if mesenchymal lesion or a tumor-like inflammatory and reparative-like lesion is a matter for differential diagnosis.
Surgical resection is the commonest therapy, but corticosteroids, NSAIDs and chemotherapy are also used.
Two years after IPT excision with no histological evidence of malignancy, our patient is feeling well with no signs of relapse. In this as well as in other similar cases we would suggest a long-term follow-up.
Keywords
cervix; inflammatory pseudotumor; immunohistochemistry; p53
Hrčak ID:
279201
URI
Publication date:
27.11.2008.
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