Oligoclonal T-cell populations in an inflammatory pseudotumor of the pancreas possibly related to autoimmune pancreatitis: An immunohistochemical and molecular analysis

Irene Esposito, Frank Bergmann, Roland Penzel, Fabio F. Di Mola, Shailesh Shrikhande, Markus W. Büchler, Helmut Friess, Herwart F. Otto

Research output: Contribution to journalArticlepeer-review

42 Scopus citations

Abstract

Inflammatory pseudotumors (IPT), also known as inflammatory myofibroblastic tumors (IMT), are benign inflammatory processes that may have an infectious etiology and are very rare in the pancreatico-biliary region. Recent studies suggest a biological distinction between IPT and IMT, the latter being a true neoplastic process. We describe a case of pancreatic IPT, originally diagnosed as malignancy, which presumably recurred 4 months after the operation. Histologically, the tumor consisted of a smooth muscle actin and CD68-positive spindle cell population and a more abundant mononuclear inflammatory cell population, primarily composed of macrophages and T-lymphocytes. Inflammatory cells were the source of connective tissue growth factor and transforming growth factor-β1 and tended to accumulate around nerves and blood vessels, as well as around residual pancreatic parenchymal elements, where an intense angiogenetic response was detected. Comparative genomic hybridization analysis of the tumor showed no chromosomal imbalances. Polymerase chain reaction-based analysis of T-cell receptor γ gene rearrangement revealed an oligoclonal pattern. These findings suggest that the pathogenesis of aggressive cases of IPT could be related to the development of an intense and self-maintaining immune response, with the emergence of clonal populations of T-lymphocytes. The relation of the pancreatic IPT to autoimmune pancreatitis is emphasized.

Original languageEnglish
Pages (from-to)119-126
Number of pages8
JournalVirchows Archiv
Volume444
Issue number2
DOIs
StatePublished - Feb 2004
Externally publishedYes

Keywords

  • Autoimmune pancreatitis
  • Inflammatory pseudotumor
  • Pancreas
  • TCRγ-rearrangement

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