1. Radiologic Features of Inflammatory Pseudotumor of the Ureter
Chisa Hosokawa, ect AJR:188, February 2007
Department of Radiology, Kosaiin Hospital,ect.Japan.
Presenter: Int 林彥斌
Indicator: Dr.順星橋

2. Introduction
Inflammatory myofibroblastic tumor: a rare benign condition of unknown cause.
Simulate malignancy, spindle cells, extracellular collagen, lymphocytes, and plasma cells.
Lung, various extrapulmonary sites.
In the urogenital tract, preferentially involves the bladder.
Only one report describing the CT features of the ureter [1].
Excretory urography, CT, MRI, retrograde pyelography, renal angiography, and gallium scintigraphy.

3. Case Report Previously healthy 66-year-old man
Left hydronephrosis during a medical checkup
PE: WNL
Lab: Microscopic hematuria, Cytology(-)
Gallium scan(-)

10. Discussion(一)
Difficulty in differentiating from malignancy before surgery.
Pseudosarcoma or plasma cell granuloma
Electron microscopic and immunohistochemical findings
Inflammatory myofibroblastic tumor :
Proliferating spindle cells with a characteristic fibro-inflammatory appearance.

11. Discussion(二) Histogenesis: uncertain, most likely a reactive process
Young patients, but wide age distribution
Most organs and anatomic sites.
Insidious or rapid
Generally indolent manner

12. Discussion(三) Varies with its location:
Solid circumscribed, multinodular, polypoid, or a locally aggressive infiltrative.
Capsule is usually not present.
Accurate histologic diagnosis requires a large amount of tissue and cannot be done by a needle biopsy

13. Discussion(四)
CT did not clarify the relationship of the mass to the ureter.
Irregular margin, neovascularization, tumor stain, suggested a malignant tumor.
MDCT and MRI might provide better delineation the possibility of a benign tumor

14. Thank you for attention~