ArticleThe American journal of surgical pathology2019
Morphologic Overlap Between Inflammatory Myofibroblastic Tumor and IgG4-related Disease: Lessons From Next-generation Sequencing.
Article in The American journal of surgical pathology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Systematic literature review of the epidemiology of neurotrophic tyrosine receptor kinase positive solid tumor sites.Future oncology (London, England) · 2025Pooled it
- Meningioma-like inflammatory myofibroblastic tumor of the lung with TPM3::ALK fusion.Virchows Archiv : an international journal of pathology · 2026Article
- Mandibular Inflammatory Myofibroblastic Tumors: A Literature Review with a New Case Presentation.Current oncology (Toronto, Ont.) · 2026Review
- Uterine leiomyoma-like inflammatory myofibroblastic tumor: two case reports and literature review.Frontiers in oncology · 2026Article
- Case Report: Hepatic inflammatory myofibroblastic tumor versus hepatic inflammatory pseudotumor in pediatric patients.Frontiers in pediatrics · 2026Article
- Primary Mesenteric Well-Differentiated Inflammatory Liposarcoma With Mucosal Extension: A Lesion With High Risk for Misdiagnosis.Case reports in surgery · 2025Article
- Inflammatory myofibroblastic tumor from molecular diagnostics to current treatment.Oncology research · 2024Review
- A rare case of inflammatory myofibroblast tumor of the stomach successfully treated by inverted laparoscopic and endoscopic cooperative surgery.Surgical case reports · 2023Article
- Hepatic Inflammatory Pseudotumor-Focusing on Its Heterogeneity.Diagnostics (Basel, Switzerland) · 2023Review
- Uncommon Benign Neoplasms and Pseudotumors of the Liver.Archives of pathology & laboratory medicine · 2023Article
- Evaluation of Orbital Lymphoproliferative and Inflammatory Disorders by Gene Expression Analysis.International journal of molecular sciences · 2022Article
- ANCA-associated vasculitis and IgG4-related disease overlap syndrome: a case report and literature review.Immunologic research · 2022Review
- Mass-forming immunoglobulin G4-related disease shows indolent clinical course after surgical resection, clinicopathological analysis of a series of 15 cases.Virchows Archiv : an international journal of pathology · 2022Article
- Unusual diagnosis in a patient presenting with fever and bilateral lung infiltrates.Breathe (Sheffield, England) · 2021Article
- Algorithmic Approach to Fibroinflammatory Sinonasal Tract Lesions.Head and neck pathology · 2021Article
- Needle biopsy compared with surgical biopsy: pitfalls of small biopsy in histologial diagnosis of IgG4-related disease.Arthritis research & therapy · 2021Article
- [IgG4-associated lung disease with granulomatous lesions : Coexistence of two entities or the spectrum of one disease?]Der Pathologe · 2021Article
- Clinical characteristics and outcomes of 17 cases of inflammatory myofibroblastic tumor at a University Hospital in China.Oncology letters · 2021Article
- Comprehensive Gene Analysis of IgG4-Related Ophthalmic Disease Using RNA Sequencing.Journal of clinical medicine · 2020Article
- Malignant transformation of inflammatory myofibroblastic tumor of urinary bladder: A rare case scenario.Bladder (San Francisco, Calif.) · 2019Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
Inflammatory myofibroblastic tumor (IMT), a locally aggressive neoplasm capable of metastasis, may show an immunoglobulin (Ig)G4-rich lymphoplasmacytic infiltrate. Prior reports suggest that storiform-fibrosis and obliterative phlebitis aid in the distinction of IMT from IgG4-related diseases. Herein, we highlight the morphologic overlap between the 2 diseases, and emphasize the importance of a multiplex fusion assay in the distinction of IgG4-related disease (IgG4-RD) from IMT. We identified 7 IMTs with morphologic and immunohistochemical features of IgG4-RD; 3 patients were originally diagnosed with IgG4-RD. Demographic, clinical and morphologic data was recorded. We also reevaluated 56 patients with IgG4-RD. We performed immunohistochemistry for IgG4, IgG, ALK, and ROS1. In situ hybridization for IgG4 and IgG was performed in selected cases. A multiplex next-generation sequencing-based RNA assay for gene fusions was performed to detect all known IMT-related gene fusions. All 7 IMTs showed a dense lymphoplasmacytic infiltrate and storiform-type fibrosis, with obliterative phlebitis noted in 3 cases. The neoplastic stromal cells constituted <5% of overall cellularity and stromal atypia was either absent or focal and mild. Elevated numbers of IgG4 positive cells and increased IgG4 to IgG ratio was identified in all cases. Four cases showed ALK related abnormalities: 3 fusions and one alternative transcription initiation; while 2 patients showed ROS1 and NTRK3 fusions. One tumor was negative for known IMT-related gene fusions. All 56 IgG4-RD cases were negative for ALK and ROS1 on immunohistochemistry; 6 cases were negative on the fusion assay. Highly inflamed IMTs are indistinguishable from IgG4-RD both histologically and on immunohistochemistry for IgG4. We advocate scrutinizing patients with presumptive single organ IgG4-RD for IMT and the diagnostic algorithm should include ALK and ROS1 immunohistochemistry and, in selected cases, a next-generation sequencing-based fusion assay that covers known IMT-associated gene fusions.
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