Hepatic Inflammatory Myofibroblastic Tumor:a Clinical Analysis Of24Cases

Objective:To study the clinical characteristics, diagnosis, treatment and prognosis of the Hepatic inflammatory myofibroblastic tumor(HIMT).Methods:24HIMT cases were involved in the study from Guangxi Tumor Hospital and The first Affiliated Hospital of Guangxi Medical University during recent10years and analyzed retrospectively.15cases underwent operation,8cases had percutaneous biopsy guided by B ultrasound,1cases underwent operation biopsy.Results:The cause of HIMT is still unclear now, may be caused by various bacteria, viruses and parasite infection. HIMT patients manifest right upper abdomen pain and fever usually. Preoperative laboratory examinations showed AFP、CEA、CA19-9、CA125normal. HBsAg found positive only in11patients. In dynamic enhanced CT or MRI scan, most tumor lesions demonstrated peripheral enhancement or septal enhancement during delayed phase. Pathological examination showed fusiform cells arranging in fascicles within the collagen matrix with lymphocytes and plasma cells infiltrating. Immunohistochemistry showed that the spindle cells expressed Vimentin(8/8) and smooth muscle actin (8/8) was positive.15cases underwent complete tumor resection, while9cases only had biopsy. The median follow-up was46months. 5patients were lost during follow-up,19patients were still alive,6patients that took conservative treatment were found disappearing of tumor.Conclusions:HIMT has nonspecific clinical manifestation. Dynamic enhanced CT or MRI scan can reflect its histopathologic characteristics and be of great value in diagnosis. Pathological examination was charateristic by multiple inflammatory cells infiltration. Immunohistochemistry showed that the spindle cells expressed Viinentin and Smooth Muscle Actin was positive. The prognosis of conservative treatment is good. Surgical resection is recommended when the diagnosis is in doubt or malignant tumor can not be excluded.