Document Type: Case Reports

Authors

1 Dept. Of Pathology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey

2 Dept. Of Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey

10.7508/ijp.2015.02.010

Abstract

Although the majority of mesenchymal lesions of the gastrointestinal tract are neoplastic in nature, but nonneoplastic reactive processes may also involve the gastrointestinal tract and mesentery. Some more aggressive neoplasms located in same area, such as fibromatosis or gastrointestinal stromal  tumors  may  be  cause  of  diagnostic  confusion.  Reactive  nodular  fibrous  pseudo  tumor (RNFP) of the gastrointestinal tract and mesentery is a recently recognized entity. Here we present one such lesion in 71 years-old- man with a history of abdominal surgery. The tumor was firm, tan–white colored, ranged in size 19.5 cm in greatest dimension, and was grossly well circumscribed. Histologically it is composed of spindle-shaped cells resembling fibroblasts arranged haphazardly or in intersecting fascicles, embedded in a collagen-rich stroma with sparse intralesional lymphoid cells frequently arranged in aggregates. We present a case of this entity have largest tumor and also due to the rarity.

Keywords

  1. Yantiss RK, Nielsen GP, Lauwers GY, Rosenberg AE. Reactive nodular fibrous pseudotumor of the gastrointestinal tract and mesentery. A clinicopathologic study of five cases. Am J Surg Pathol 2003:27(4):532-40.
  2. Daum O, Vanecek T, Sima R, Curik R, Zamecnik M, Yamanaka S, et al. Reactive nodular fibrous pseudotuumors of the gastrointestinal tract: report of 8 cases. Int J Surg Pathol 2004:12(4):365-74.
  3. Saglam EA, Usubutun A, Kart C, Ayhan A, Kucukali T. Reactive nodular fibrous pseudotumor involving the pelvic and abdominal cavity: a case report and review of literature. Virchows Arch 2005: 447(5):879-82.
  4. Gauchotte G, Bressenot A, Serradori T, Boissel P, Plénat F, Montagne K. Reactive nodular fibrous pseudotumor:  A  first  report  of  gastric  localization  and clinicopathologic review.  Gastroenterol Clin Biol 2009:33(12):1076-81.
  5. Brainard JA, Goldblum JR. Stromal tumors of the jejunum and ileum: a clinicopathologic study of 39 cases. Am J Surg Pathol 1997:21(4):407-16.
  6. Burke AP, Sobin LH, Shekitka KM, FederspielBH, Helwig EB. Intra-abdominal fibromatosis:a pathologic analysis of 130 tumors with comparison of clinical subgroups. Am J Surg Pathol 1990:14(4):335-41.
  7. Coffin  CM,  Humphrey  PA,  Dehner  LP.  Extrapulmonary  inflammatory  myofibroblastic  tumor:  a  clinical and pathological survey. Semin Diagn Pathol 1998:15(2):85-101.
  8. Miettinen M. Are desmoid tumors kit positive? Am J Surg Pathol 2001:25(4):549-50.
  9. Fetsch JF, Montgomery EA, Meis JM. Calcifying fi,-brous pseudotumor. Am J Surg Pathol 1993:17(5):502-8.
  10. Nascimento AF, Ruiz R, Hornick JL, Fletcher CD. Calcifying  fibrous  ‘‘pseudotumor’’:  clinicopathologic study of 15 casesand analysis of its relationship to inflammatory  myofibroblastic  tumor.  Int  J  Surg  Pathol 2002:10(3):189-96.
  11. Hill KA, Gonzalez-Crussi F, Chou PM. Calcifying fibrous  pseudotumor  versus  inflammatory  myofibroblastic tumor: a histological and immunohistochemical comparison. Mod Pathol 2001:14(8):784-90.
  12. Miettinen M, Monihan JM, Sarlomo-Rikala M, Kovatich AJ, Carr NJ, Emory TS, et al.Gastrointestinal stromal tumors/smooth muscle tumors (GISTs) primary in the omentum and mesentery. Clinicopathologic and immunohistochemical study of 26 cases. Am J Surg Pathol 1999:23(9):1109-18.
  13. Coffin CM, Dehner LP, Meis-Kindblom JM. Inflammatory  myofibroblastic  tumor,  inflammatory  fibrosarcoma, and related lesions: An historical review with differential diagnostic considerations. Semin Diagn Pathol1998:15(2):102-10.
  14. Makhlouf HR, Sobin LH. Inflammatory myofibroblastic tumors (inflammatory pseudotumors) of the gastrointestinal tract: how closely are they related to inflammatory fibroid polyps? Hum Pathol 2002:33(3):307-15.
  15. Zardawi IM, Catterall N, Cox SA. Reactive nodular fibrous pseudotumor of the gastrointestinal tract and mesentery. Am J Surg Pathol 2004:28(2):276-7.