Intranodal palisaded myofibroblastoma is a rare and benign tumor that usually presents in the inguinal region. We report the case of a 68-year-old woman with a right paratracheal mass and right upper lobe non-small cell lung carcinoma initially staged as T1b N2 M0. After mediastinal staging, the right paratracheal mass was found to be an intranodal palisaded myofibroblastoma, which had caused erroneous upstaging of the lung carcinoma to N2 disease. This had the potential of leading to suboptimal treatment of the primary lung carcinoma if formal mediastinal staging had not been performed. To the best of our knowledge, this is the first report in the English literature of an intranodal palisaded myofibroblastoma occurring concurrently with lung cancer. This case highlights the importance of mediastinal staging in lung cancer. Mediastinoscopy remains the gold standard.
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Intranodal palisaded myofibroblastoma in the submandibular gland region: a case report.
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Intranodal palisaded myofibroblastoma (IPM) is a rare stroma-derived spindle-cell neoplasm of the lymph node with myofibroblastic differentiation and CTNNB1 (β-catenin gene) somatic mutations. We present a case of IPM found incidentally in the staging of lung adenocarcinoma. We describe the major histopathological and phenotypic features, including a palisaded bland spindle cell proliferation with myofibroblastic differentiation and Wnt pathway activation by immunohistochemistry, including β-catenin expression.
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Intranodal palisaded myofibroblastoma is a rare benign tumor of the lymph nodes, that arises from smooth muscle cells or myofibroblast, chiefly in the inguinal lymph nodes. Intranodal palisaded myofibroblastoma of the parotid gland is exceedingly scarce, even more, its recurrent characteristic; which underlines the grave importance of a long, strict monitoring and surveillance plan. Alongside these salient points in this unusual case, we also aim to highlight the peculiar difficulties inevitably faced, given the unfortunate lack of typical pathognomonic clinical and radiological features.
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