염증성 근섬유모세포종 10예의 면역조직화학염색 소견
Immunohistochemical Findings in 10 Cases of Inflammatory Myofibroblastic Tumor
정수진, 강미선, 이창훈, 홍숙희, 윤혜경,
소속 상세정보
정수진 ( Jung Soo-Jin )
인제대학교 의과대학 부산백병원 해부병리학교실
강미선 ( Kang Mi-Seon )
인제대학교 의과대학 부산백병원 해부병리학교실
이창훈 ( Lee Chang-Hoon )
부산대학교병원 해부병리과
홍숙희 ( Hong Sook-Hee )
동아대학교병원 해부병리과
윤혜경 ( Yoon Hye-Kyoung )
인제대학교 의과대학 부산백병원 해부병리학교실
KMID : 0357919990330090717
Abstract
A wide range of denomination has been used for inflammatory myofibroblastic tumor (IMT). IMT is not entirely homogeneous, even though it shows some overlapping histologic features such as haphazard proliferation of spindle cell and polymorphic chronic inflammatory cell infiltraion. The spindle cell is considered to be of myofibroblastic origin but follicular dendritic cell origin was reported recently. IMT is known as nonneoplastic, aberrant inflammatory response. However, IMT could show local invasion, recurrence, vascular invasion, and malignant transformation, and clonal characteristics and aneuploidy of IMT support the hypothesis that IMT may be a neoplastic process. In order to define the nature of spindle cell of IMT, immunohistochemical stains for smooth muscle actin (SMA), vimentin (VMT), lysozyme, S-100 protein, cytokeratin, CD21 were done. Additional immunohistochemical stains for MIB-1 for proliferating activity and LMP (latent membrane protein) for Epstein-Barr virus (EBV) were done. IMTs were composed of each 2 cases from lung, liver and lymph node and one case from common bile duct, maxillary sinus, bladder and thigh, and were histologically subclassified according to Coffin et al. Nine cases (90%) were positive for SMA and VMT, but no correlation between SMA and VMT immunoreactivity and histologic types was identified. Five cases (50%) were positive for lysozyme and S-100 protein, and histologic type III was negative for lysozyme and S-100 protein, and immunoreactivity for S-100 protein was different according to the histologic subtypes. All 11 cases were negative for CD21 and EBV LMP. MIB-1 labelling index was less than 1% in all cases. In summary, the spindle cell is regarded as myofibroblastic origin rather than follicular dendritic cell origin. Relationship with EBV is not clear, and negligible MIB-1 reaction suggests that IMT might have a good prognosis.
키워드
Inflammatory myofibroblastic tumor;Immunohistochemistry
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