We report 11 Japanese cases of inflammatory pseudotumor (IPT) of the lymph node. There were 7 males and 4 females with ages ranging from 5 to 68 years (median; 48). Only 2 patients had systemic lymphadenopathy, and all others had involvement of only 1 lymph node group. Constitutional symptoms such as fever were present in 8 patients and laboratory abnormalities were detected in 5. All patients recovered and were alive and well after 2 to 180 months (median; 32 months). Histologically, the process mainly involved the connective tissue framework of the lymph node, secondarily spreading into the lymph node parenchyma and the perinodal tissue. It was characterized by a storiform growth pattern of myofibroblasts, marked vascularity with associated vascular lesions, and a polymorphous reactive cellular infiltrate in a collagen-rich stroma. An immunohistochemical study revealed numerous myofibroblasts, histiocytes, and vascular endothelial cells expressing vascular endothelial growth factor (VEGF) in 6 cases. It was suggested that VEGF may be involved, in part, in the induction of the angiogenesis of IPT. Moreover, the present study indicates that follicular dendritic cell sarcoma, nasal T/natural killer cell lymphoma, and anaplastic large cell lymphoma should be added to the differential diagnosis from IPT of the lymph node.
1. Spencer H. The pulmonary plasma cell/histiocytoma complex. Histopathology8:903-916, 1984
2.
2. Horiuchi R, Uchida T, Kojima T, Shikata T. Inflammatory pseudotumor of the liver: Clinicopathologic study and review of the literature. Cancer65: 1583-1590, 1990
3.
3. Thomas RM, Jaffe ES, Zerate-Osorno A, Medeiros LJ. Inflammatory pseudotumor of the spleen. A clinicopathologic and immunophenotypic study of eight cases. Arch Pathol Lab Med117:921-926, 1993
4.
4. Coffin CM, Watterson J, Priest JR, Dehner LP. Extrapulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor). A clinicopathologic and immunohistochemical study of 84 cases. Am J Surg Pathol19:859-872, 1995
5.
5. Perrone T, De Wolf-Peeters C, Frizzera G. Inflammatory pseudotumor of lymph nodes: A distinct pattern of nodal reaction. Am J Surg Pathol12:351-361, 1988
6.
6. Facchetti F, De Wolf Peeters C, De Wever I, Frizzera G. Inflammatory pseudotumor of lymph nodes. Immunohistochemical evidence for its fibrohistiocytic nature. Am J Pathol137:281-289, 1990
7.
7. Davis RE, Warnke RA, Dorfman RF. Inflammatory pseudotumor of lymph nodes. Additional observations and evidence for an inflammatory etiology. Am J Surg Pathol15:744-756, 1991
8.
8. New NE, Bishop PW, Stewart M, Banerjee SS, Harris M. Inflammatory pseudotumor of lymph nodes. J Clin Pathol48:37-40, 1995
9.
9. Menke DM, Griesser H, Araujo I, Foss H-D, Herbst H, Banks PM, Stein H. Inflammatory pseudotumor of lymph node origin show macrophage-derived spindle cells and lymphocyte-derived cytokine transcripts without evidence of T-cell receptor gene rearrangements. Implications for pathogenesis and classification as an idiopathic retroperitoneal fibrosis-like sclerosing immune reaction. Am J Clin Pathol105:430-439, 1996
10.
10. Moran CA, Suster S, Abbondanzo SL. Inflammatory pseudotumor of lymph nodes: A study of 25 cases with emphasis on morphological heterogeneity. Hum Pathol28:332-338, 1997
11.
11. Arber DA, Kamel OW, van de Rijn M, Davis RE, Medeiros LJ, Jaffe ES, Weiss LM. Frequent presence of the Epstein-Barr virus in inflammatory pseudotumor. Hum Pathol26:1093-1098, 1996
12.
12. Mcnicol AM, Richmond JA. Optimizing immunohistochemistry: Antigen retrieval and signal amplification. Histopathology32:97-103, 1998
13.
13. Nakamura S, Shiota M, Nakagawa A, Yatabe Y, Kojima M, Motoori T, Suzuki R, Kagami Y, Ogura M, Morishima Y, Mizoguchi Y, Okamoto M, Seto M, Koshikawa T, Mori, S, Suchi T. Anaplastic large cell lymphoma: A distinct molecular pathology entity. A reappraisal with special reference to p8ONPM/ALK expression. Am J Surg Pathol21:1420-1432, 1997
14.
14. Chan JKC, Fletcher CDM, Nayler SJ, Cooper K. Follicular dendritic cell sarcoma. Clinicopathologic analysis of 17 cases suggesting a malignant potential higher than currently recognized. Cancer79;294-313, 1997
15.
15. Nakamura S, Suchi T, Koshikawa T, Kitoh K, Koike K, Komatsu H, lida S, Kagami Y, Ogura M, Katoh E, Kurita S, Suzuki H, Kobashi Y, Yamabe H, Hirabayashi N, Ueda R, Takahashi, T. Clinicopathologic study of CD56 (NCAM)-positive angiocentric lymphioma occuring in sites other than upper and lowerespiratory tract. Am J Surg Pathol19:284-296, 1995
16.
16. Jaffe ESChan JKC, Su I-J, Frizzera G, Mori S, Feller AC, Ho FCS. Report of the workshop on nasal and relate I extranodal angiocentric T/natural killer cell lymphomas. Definitions, differential daioagnosis, and epidemiology. Am J Surg Pathol20:103-111, 1996
17.
17. Cheuk WV, Hill RW, Bacchi C, Antonio Dias M, Chan JKC. Hypocellular anaplastic large cell lymphoma mimicking inflammatory lesions of lymph nodes. Am J Surg Pathol24:1537-1543, 2000
18.
18. Imai Y, Yamakawa M. Morphology, function and pathology of follicular dendritic cells. Pathology Internalional46:807-833, 1996
19.
19. Raymor d I, Saati TAI, Tkaczuk J, Chittal S, Delsol G. CAN.42, a new monoclonal antibody directed against a fixative-resistant antigen of follicular dendritic reticulm cells. Am J Pathol151:1577-1585, 1997
20.
20. Chan JKC, Sin VC, Wong KF, Ng CS, Tsang WYW, Chan CH, Cheung MMC, Lau WH. Nonnasal lymphoma expressing the natural killer cell marker CD56: A clinicopathologic study of 49 cases of uncommon aggressive neoplasm. Blood89:4501-4513, 1997
21.
21. Felgar RE, Macon WR, Kinney MC, Roberts S, Pasha T, Salhany KE. TIA-1 expresion in lymphoid neoplasms. Identification of subsets with cytotoxic T lymphocyte or natural killer cell differentiation. Am J Pathol150:1893-1900, 1997
22.
22. Kagami Y, Suzuki R, Taji H, Yatabe Y, Takeuchi T, Maeda S, Kondo E, Kojima M, Motoori T, Mizoguchi Y, Okamoto M, Ohnishi K, Yamabe H, Seto M, Ogura M, Koshikawa T, Takahashi T, Kurita S, Morishima Y, Suchi T, Nakamura S. Nodal cytotoxic lymphoma spectrum. A clinicopathologic study of 66 patients. Am J Surg Pathol23:1184-1200, 1999
23.
23. Kummer JA, Kamp AM, van Katwijk M, Brakenhoff JPJ, Rado'sevie K, van Leeuwen AM, Borst J, Verweij CL, Hack CE. Production and characterization of monoclonal antibodies raised against recombinant human granzyme A and B showing cross reactions with the natural proteins. J Immunol Methods163:77-83, 1993
24.
24. Anderson P. TIA-1: stractural and functional studies on a new class of cytotoxic effector molecule. Cur Top Microbiol Immunol198:131-143, 1995
25.
25. Foss H-D, Araujo I, Demel G, Klotzbach H, Hunmel M, Stein H. Expression of vascular endothelial growth factor in lymphomas and Castleman's disease. J Pathol183:44-50, 1997
