Mahfuz TURAN, Remzi ERTEN, Mehmet Deniz BULUT, Gülay BULUT, Ayşe Öter ALMALI, İrfan BAYRAM

Laringeal inflamatuar myofibroblastik tümör: Nadir bir olgu

İnflamatuar myofibroblastik tümör malignite potansiyeli belirsiz, borderline bir neoplazmdır. En sık yerleşim yeri akciğerlerdir. Baş-boyun bölgesinde larinks yerleşimi oldukça nadirdir. On-bir yaşında kız hastanın üç yıldır devam eden ses kısıklığı şikayeti vardı. Yapılan laringoskopide sol vokal kordu boylu boyunca tutan, geniş tabanlı polipoid doku izlendi. Polipoid doku tamamen eksize edildi. Yapılan histopatolojik incelemede miksoid bir stroma içerisinde mikst iltihabi infiltratla karışık halde, intranükleer psödoinklüzyonları olan çok sayıda miyofibroblast izlendi. Belirgin atipi, mitoz, nekroz görülmedi. Yapılan immünhistokimyasal incelemede neoplastik hücrelerde vimentin, ALK, EMA ile pozitif boyanma izlendi. Alcian blue ile miksoid stromada boyanma görüldü. Histopatolojik ve immünhistokimyasal bulgular eşliğinde olguya laringeal inflamatuar miyofibroblastik tümör tanısı konuldu. Nadir bir antite olan laringeal inflamatuar myofibroblastik tümör, malign laringeal tümörlerden mutlaka ayırt edilmelidir. Doğru teşhis, hastada gereksiz agresif tedavi yöntemlerinden kaçınmayı ve inflamatuar myofibroblastik tümör için yeterli olan organ koruyucu komplet rezeksiyon yapılmasını sağlar

Laryngeal inflammatory myofibroblastic tumor: A rare case

Inflammatory myofibroblastic tumor is a borderline neoplasm with uncertain malignant potential. The most frequent site of localization is the lungs. The localization in larynx in the head-neck area is rather rare. The 11-year-old female patient had the symptom of hoarse voice, which had been continuing for three years. The laryngoscopy performed showed a polypoid tissue with a wide base, which involved the left vocal cord at full length. The polypoid tissue was completely excised. The histopathological examination performed demonstrated several myofibroblasts with intranuclear pseudoinclusions, which were surrounded by mixed inflammatory infiltrates in a myxoid stroma. No significant atypia, mitosis and necrosis were observed. The immunochemistry stains were positive for Vimentin, ALK and EMA in neoplastic cells. Alcian blue stain was positive in the myxoid stroma. The case was diagnosed with laryngeal inflammatory myofibroblastic tumor in the light of histopathological and immunohistochemical findings. Laryngeal inflammatory myofibroblastic tumor, a rare entity, should definitely be distinguished from malignant laryngeal tumors. Accurate diagnosis ensures that unnecessary and aggressive treatment methods are avoided and complete, organ-salvaging resection adequate for the inflammatory myofibroblastic tumor be conducted.

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