Virchows Archiv

, Volume 448, Issue 5, pp 552–560

Pancreatic malignant fibrous histiocytoma, inflammatory myofibroblastic tumor, and inflammatory pseudotumor related to autoimmune pancreatitis: characterization and differential diagnosis

Authors

  • Hiroki Mizukami
    • Department of PathologyHirosaki University School of Medicine
  • Nobuhisa Yajima
    • Department of PathologyHirosaki University School of Medicine
  • Ryuichi Wada
    • Department of PathologyHirosaki University School of Medicine
  • Kazuhito Matsumoto
    • Division of Surgical PathologyNational Hirosaki Hospital
  • Motohiro Kojima
    • Department of PathologyUniversity of Kiel
  • Günter Klöppel
    • Department of PathologyUniversity of Kiel
    • Department of PathologyHirosaki University School of Medicine
Original Article

DOI: 10.1007/s00428-006-0157-x

Cite this article as:
Mizukami, H., Yajima, N., Wada, R. et al. Virchows Arch (2006) 448: 552. doi:10.1007/s00428-006-0157-x

Abstract

Malignant fibrous histiocytoma (MFH) and inflammatory myofibroblastic tumor (IMT) are uncommon primary non-epithelial cell tumors of the pancreas. In addition, there are inflammatory pseudotumors (IPT) that may arise in the course of autoimmune pancreatitis (AIP). In the English language literature, only 24 cases of IMT and nine cases of MFH in the pancreas have been reported to date. We investigated three individual spindle cell tumors of the pancreas that were identified as MFH, IMT, and IPT, respectively, using immunohistochemical and molecular analysis. Both the MFH and the IMT, but not the IPT, showed nuclear p53 expression and mutations of the p53 gene. The MFH and the IMT also had higher mitotic and Ki-67 (MIB-1) indexes than the IPT. The IPT was found to be a tumor-like case of AIP. Many IgG4-positive plasma cells, which are considered to be a feature of AIP, were found in all three tumors. It is concluded that in this series of spindle cell tumors of the pancreas, apart from immunohistochemical features, the demonstration of p53 mutations may be helpful in distinguishing true neoplastic tumors from pseudotumors such as IPTs arising in the context of AIP.

Keywords

Pancreatic tumorMalignant fibrous histiocytomaInflammatory myofibroblastic tumorAutoimmune pancreatitisp53 mutation

Copyright information

© Springer-Verlag 2006