Focal myositis of esophagus: a distinct inflammatory pseudotumor mimicking esophageal malignancy.
9
Citation
0
Reference
10
Related Paper
Citation Trend
Abstract:
Focal myositis is a benign pseudotumor of skeletal muscle that usually occurs in the soft tissue of the extremities. Clinically, it grows rapidly but usually regresses spontaneously and is often misdiagnosed as a malignancy. We report a case of focal myositis occurring in the upper esophagus and presenting as a rapidly growing submucosal tumor with severe esophageal stenosis and dysphagia. It was misdiagnosed preoperatively as esophageal malignancy. Histologically, it was characterized by the presence of various-sized skeletal muscle fibers with interstitial inflammation and fibrosis. The pathological pictures are identical to polymyositis or dermatomyositis, but the stenosis was relieved after operation without recurrence, and levels of the polymyositis-associated autoantibodies and serum enzymes were not elevated. Therefore, clinical and histological information is needed to make a correct diagnosis.Cite
Most esophageal malignancies are either squamous carcinomas or adenocarcinomas arising in the background of Barrett's esophagus. We describe a case of an 85-yr-old woman in whom the diagnosis of esophageal malignancy was difficult to confirm despite its endoscopic appearance and previous biopsies. This case illustrates the difficulty in diagnosing Hodgkin's disease of the esophagus. Despite the rarity of this entity, if clinically indicated by symptoms, large, deep biopsies by rigid esophagoscopy should be considered.
Esophageal disease
Cite
Citations (2)
This is a case report of a malignant mesenchymoma of the esophagus in a 50−year‐old Japanese man. The tumor was a sessile polypoid mass showing a downward invasion limited to the submucosa of the esophagus. Histologically, the lesion contained rhabdomyosarcomatous and osteosarcomatous areas, in addition to an ill‐defined fibrosarcomatous element. In contrast with reports of carcinosarcoma up to the present, this tumor lacked any invasive lesion of an epithelial malignancy. The morphogenesis of these tumor groups was discussed from a hamartoblastomatous standpoint. Acta pathol. jpn. 34: 925∼933, 1984.
Carcinosarcoma
Submucosa
Cite
Citations (6)
The fine needle aspiration (FNA) cytologic features are described in a case of inflammatory pseudotumor of the liver (xanthogranuloma), a disease generally regarded as of unknown etiology. The initial FNA findings were those of an acute exudative process, with atypical biliary duct epithelium and hepatocytes. These were interpreted as verifying the radiologic impression of a malignancy. Histologic study of subsequently resected nodules revealed the true nature of the case. As the lesion evolved, granulomatous inflammation supervened, characterized by numerous foamy histiocytes and lesser populations of plasma cells and lymphocytes. Numerous gram-positive cocci were readily demonstrated, suggesting that the lesion was an unusual tissue response to an intrahepatic bacterial infection. The lesion eventually resolved with prolonged antibiotic therapy.
Cytopathology
Cholangiocyte
Cite
Citations (73)
From 1950 to 1973, 169 patients received irradiation for esophageal squamous cell carcinoma. The average survival time was 10 months, with 7% of the patients living 2 years or more. The median survival time was 7 months; palliation averaged 6 months. Most completing therapy (89%) achieved some palliation: 66% had significant relief of dysphagia for 2 months or longer. The anatomical location of the malignant obstruction did not influence therapeutic response: there was similar response in cases of upper, middle, and lower esophageal lesions. Thirty patients with progressive obstruction underwent endoesophageal intubation with Celestin tube placement; this procedure provided symptomatic relief with minimal morbidity.
Esophageal disease
Palliative Treatment
Cite
Citations (82)
Inflammatory pseudo tumor (IPT) also known as inflammatory myofibroblastic tumor (IMT) is a tumor like mass of inflammatory origin. It is a pseudo sarcomatous lesion that has been reported most commonly in liver, followed by lung, mesentery and omentum but very rarely seen in esophagus. Proliferation of myofibroblastic cells is more in IMT. In IPT it is more of an inflammatory reactive or regenerative entity and has an overlapping with immunoglobulin G4-related disease. Lesion often mimics malignancy. A 20 year old male patient with history of dysphagia, more for liquids, underwent CT thorax, showing dilated oesophagus, with a moderately contrast enhancing eccentric soft tissue density lesion involving mid and lower esophagus extending for a length of 6cm. Patient underwent right thoracotomy, and a 5x3x3cm hard lesion involving lower esophagus was excised. Histopathology pointed towards inflammatory myofibroblastic tumor or inflammatory pseudotumor. Proliferation of myofibroblastic cells is more in IMT. In IPT it is more of an inflammatory reactive or regenerative entity and has an overlapping with immunoglobulin G4-related disease. Lesion often mimics malignancy.
Thoracotomy
Histopathology
Cite
Citations (0)
Cite
Citations (10)
Perforation
Medical Therapy
Esophageal disease
Barrett's esophagus
Cite
Citations (8)
Focal myositis is a benign pseudotumor of skeletal muscle that usually occurs in the soft tissue of the extremities. Clinically, it grows rapidly but usually regresses spontaneously and is often misdiagnosed as a malignancy. We report a case of focal myositis occurring in the upper esophagus and presenting as a rapidly growing submucosal tumor with severe esophageal stenosis and dysphagia. It was misdiagnosed preoperatively as esophageal malignancy. Histologically, it was characterized by the presence of various-sized skeletal muscle fibers with interstitial inflammation and fibrosis. The pathological pictures are identical to polymyositis or dermatomyositis, but the stenosis was relieved after operation without recurrence, and levels of the polymyositis-associated autoantibodies and serum enzymes were not elevated. Therefore, clinical and histological information is needed to make a correct diagnosis.
Cite
Citations (9)
Focal myositis is a benign pseudotumor of skeletal muscle, the cause of which is obscure. It usually appears as a steadily enlarging mass within the muscle of an extremity. The pathologic features are those of an inflammatory myopathy in which lymphocytic infiltrates, muscle cell necrosis, and regeneration are seen. Four cases of focal myositis were studied using enzyme histochemistry and electron microscopy. The changes of denervation atrophy, reinnervation, and fiber hypertrophy were found. Intramuscular nerve damage manifested by axonal swelling, demyelination, and endoneurial fibrosis was evident. The findings suggest that a denervating process plays an important role in the pathogenesis of focal myositis.
Pathogenesis
Cite
Citations (51)