An Immunohistochemistry Proved Extensive Inflammatory Myofibroblastic Tumour of Lung: Being Treated with Crizotinib

Abstract

Inflammatory Myofibroblastic Tumour (IMT) is a rare entity which constitutes 0.04–1.2% of all lung tumours. Though IMT was first described as an ‘Interesting Benign Lung Tumour’, recurrence, the discovery of cytogenetic aberrations, a clonal population of cells and oncogenic protein overexpression establish it as a malignant entity. Because of similar morphology of a number of tumours comprising of spindle cells with inflammatory background only immunohistochemical investigations can conclude the correct final diagnoses. Interestingly, half of IMTs carry rearrangements of the anaplastic lymphoma kinase (ALK) locus. Though complete resection is the treatment of choice, ALK positivity opens the door for Crizotinib for the treatment of invasive, unresectable, recurrent IMTs. We report a case of an aggressive, large IMT of Left Lung with contralateral multiple nodular lung metastasis in a 50 years old male patient. From ALK locus rearrangement, this case is being treated with Crizotinib and patient has improved symptomatically after 8 weeks of treatment.