Absence of anaplastic lymphoma kinase-1 expression in inflammatory myofibroblastic tumors of the central nervous system: Does it signify a different nosologic entity from its systemic counterpart.
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Date
2014-04
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Abstract
Background and Aim: Infl ammatory myofi broblastic tumors (IMFTs) are
uncommon neoplasms of the central nervous system (CNS) of intermediate
grade biologic potential. Anaplastic lymphoma kinase (ALK-1), a diagnostic
marker of anaplastic large cell lymphoma, is also expressed in a subset of
IMFTs and appears to have prognostic signifi cance. Though, few studies have
evaluated expression of ALK-1 in IMFTs of the CNS. This retrospective study
was undertaken to evaluate the expression of ALK-1 expression in IMFT of
CNS by immunohistochemistry and correlate with the clinical, radiological and
pathologic features. Materials and Methods: Five cases diagnosed as IMFT/
infl ammatory pseudotumour/plasma cell granuloma, diagnosed in CNS over
10 year period (1998-2007) were retrieved from the archives of Department
of Neuropathology of a tertiary referralcenter. The clinical profi le and imaging
features were collected from the case records. Hematoxylin and eosin stained
sections were reviewed with immunohistochemistry for smooth muscle actin
(SMA), vimentin, desmin, ALK-1, p53, MIB-1, CD68, leukocyte common
antigen, CD3, and CD20. Results: All fi ve cases of IMFTs presented as duralbased
space occupying or en-plaque lesions. Histologically, four cases had
combined plasma cell granuloma-fi brous histiocytoma morphology, and one
had fi brous histiocytoma-like morphology. Immunohistochemically, SMA was
strongly positive in spindle cell component of the tumors confi rming diagnosis.
ALK-1 expression could not be detected by immunohistochemistry in any of
the cases. Conclusion: Further studies analyzing ALK-1 gene mutation and
rearrangements are required to determine pathogenetic role, if any, in CNS
IMFTs.
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Keywords
Anaplastic lymphoma kinase, central nervous system, infl ammatory myofi broblastic tumor, central nervous system, infl ammatory myofi broblastic tumor
Citation
Govindan Aparna, Mahadevan Anita, Chakraborti Shrijeet, Furtado Sunil, Krishna Susarla. Absence of anaplastic lymphoma kinase-1 expression in inflammatory myofibroblastic tumors of the central nervous system: Does it signify a different nosologic entity from its systemic counterpart. Indian Journal of Pathology & Microbiology. 2014 Apr-Jun 57 (2): 178- 182.