Endobronchial Inflammatory Myofibroblastic Tumor Treated by Bronchotomy
Bibliographic record
Abstract
Abstract Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal tumor with an unknown etiology. IMT mainly affects young adults and children and accounts for less than 1% of all lung tumors. Although most frequently found in the lung, IMTs can also arise in other anatomical sites and are often incidentally detected on imaging due to an asymptomatic presentation. Pulmonary IMTs typically appear radiologically as solitary solid nodules, presenting a broad differential diagnosis. Diagnosis is confirmed by histopathologic and immunohistochemical analysis, which reveals myofibroblastic spindle cells, minimal cytological atypia, and an inflammatory infiltrate of plasma cells, lymphocytes, and eosinophils. Surgical resection is the primary treatment for localized IMT. Here, we present a case of endobronchial IMT treated with bronchotomy. A 55-year-old Caucasian, non-smoking woman with a history of right breast cancer treated by mastectomy and radiotherapy presented with new-onset hemoptysis and dyspnea. Physical examination was unremarkable. Chest CT revealed a 1.1 x 1.3 cm endobronchial mass in the distal portion of the left main bronchus. Bronchoscopy identified a well-defined, highly vascularized obstructive mass. Histopathologic analysis of biopsies showed abundant spindle cells with a low mitotic index, no nuclear atypia, and lymphoplasmacytic inflammatory infiltration, confirming IMT. Immunohistochemistry was positive only for Ki67 and CD68. Pulmonary function tests prior to surgery were normal. Thoracic surgery was consulted for tumor removal. Since endoscopic resection was not feasible, a successful bronchotomy was performed to excise the mass.IMT is a rare low-grade neoplasm with limited potential for local invasion and rare metastasis. Recent data suggest that IMT may involve the anaplastic lymphoma kinase (ALK) gene as well as autoimmune and infectious mechanisms. The association with other neoplasms is notable, as some adult patients, including our case, have a history of previous malignancies. Preoperative diagnosis of IMT remains challenging due to imaging findings that often mimic traditional lung cancers and difficulties obtaining adequate biopsy samples. Therefore, complete surgical resection with negative margins remains the preferred treatment, showing a favorable prognosis and low recurrence rates. Although the endobronchial location in this case allowed for easier biopsy access via bronchoscopy, fine needle aspiration and bronchoscopic samples are often too small for a definitive diagnosis. For pulmonary IMTs, lobectomy is typically required, though bronchotomy offers a more localized and less invasive approach that helps preserve lung function. We believe this is the first reported case of adult endobronchial IMT treated with bronchotomy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".