engleski

Inflammatory Fibroid Polip - Two Case Reports

Inflammatory fibroid polyps are rare, benign, mesenchymal tumors that occur throughout gastrointestinal tract. Usually they appear as a small (few mm to 1.5 cm), solitary, sessile growths, though they can measure up to 9-10 cm. We report of 2 polyps, one arising in stomach and other in small intestine. CASE 1: 70-year- old woman underwent surgery for removal of pedunculated gastric polyp protruding in duodenum, that was too large for endoscopic polypectomy. We received polypoid tumor that measured 8, 8x5, 2x4 cm. Histologically, polyp was composed of uniform spindle cells in loose edematous fibrovascular stroma, with predominately eosinophilic and some mononuclear infiltrate. Mitotic activity was low ; 1 mitosis/50 HPF. Immunohistochemistry revealed: CD34 and vimentin were positive ; CD117, S-100, SMA, MSA and desmin were negative. Ki-67 index was 2-3%. CASE 2: 52-year-old man with unspecific abdominal pain over couple of weeks had abdominal CT scan that revealed hypodense formation in ileum that rose suspicion of tumor process (GIST, adenocarcinoma, polyp), thus the patient was treated surgically. Material sent for PHD was 30 cm long segment of small intestine containing gray tumor, 4.5 cm in diameter. Histologic examination showed tumor composed partially of spindle cells and partially of stellate cells in myxoid stroma, numerous blood vessels and inflammatory infiltrate with eosinophilic and plasma cell preponderance. 5 mitoses were found on 50 HPF, and immunohistochemistry showed: vimentin was positive ; SMA was focally positive ; CD 117, CD 34, MSA, S-100, desmin, synaptophysin and CK AE1/AE3 were negative. Ki-67 index was 15%. In both reported cases inflammatory polyp was doubted and material was sent for consultation. Following morphologic characteristics and IHC profile diagnosis of inflammatory fibroid polyp was made. We reported of 2 larger sized polypoid tumors that, although morphologically indicative of benign lesion, should be cautiously approached and immunohistochemicaly analyzed in order not to be raplaced with other neoplasms such as GIST, vascular neoplasms, schwannoma, leiomyoma etc.

inflammatory fibroid polip, diagnosis

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