2013 Volume 53 Issue 6 Pages 787-792
Background. Inflammatory myofibroblastic tumor (IMT) is a rare pulmonary tumor, accounting for only 0.04-1% of all lung tumors, that exhibits the characteristics of myofibroblast proliferation with infiltration of inflammatory cells, such as lymphocytes and plasma cells. Case. A 63-year-old male was referred to our hospital because chest computed tomography performed as a detailed examination for hemoptysis revealed a nodule in the S1+2 of the left upper lobe. Bronchoscopy showed a polypoid lesion in the left B1+2b. A definitive diagnosis was not obtained from transbronchial biopsies. Because positron emission tomography (PET) demonstrated an abnormal uptake in the nodule with an SUVmax of 13.61, suggestive of a malignant lung tumor, we performed video-assisted thoracoscopic left upper lobectomy with lymph node dissection (ND2a). Histologically, the tumor was diagnosed as IMT, having the characteristics of spindle cell proliferation with an infiltration of lymphocytes and plasma cells, and also showing the tumor cells to be positive for anaplastic lymphoma kinase (ALK). Conclusions. In cases of PET-positive endobronchial tumors, physicians should consider IMT as a differential diagnosis. In the present case, the results of immunostaining for ALK were useful for making the definitive diagnosis.
