PMC7391106_01
Representative hematoxylin and eosin (H&E) and immunohistochemical staining of inflammatory fibroid polyp (IFP). (a) Coronal (yellow arrow on mass). (b) Axial CT scan with contrast revealed ileocolonic intussusception measuring in maximum longitudinal axis about 7.4 cm. (c) Gross examination revealed a large pedunculated polypoid mass measuring 7.5 cm with attached stalk measuring 5 cm, located at the ileocecal valve. (d) Submucosal mass characterized by spindle cells embedded in a loose myxoid matrix (H&E; 2x). (e) Heavy inflammatory infiltrate with eosinophils and mast cells are observed (H&E; 20x). (f) CD34 expressed prominently in blood vessels, while tumor cells were negative (4x).
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A computed tomography (CT) scan with contrast revealed ileocolonic intussusception measuring in maximum longitudinal axis about 7.4 cm with large polypoid soft tissue mass acting as a leading point measuring about 7 cm in its maximum dimension (Figures 1(a) and 1(b)). Under prober opening and overnight formalin fixation, the specimen showed large pedunculated polypoid mass measuring 7.5 x 4 x 2 cm with attached stalk measuring 5 cm, located at the ileocecal valve (Figure 1(c)). Hematoxylin and eosin- (H&E-) stained slides revealed large well-defined submucosal mass composed of bland spindle cell lesion proliferation concentrically arranged around thick-wall blood vessels (forming onion skinning appearance) (Figure 1(d)). Background of edematous changes with mixed inflammatory cells infiltrates particularly the eosinophil were seen (Figure 1(e)). CD34 (Figure 1(f)) and CD117, discovered on GIST (DOG-1), Desmin, Caldesmon, muscle-specific antibody (MSA), smooth muscle antibody (SMA), beta-catenin, anaplastic lymphoma kinase (ALK-1), signal transducer and activator of transcription 6 (STAT6), neurofilament, cytokeratin-pan, and S-100 were all negative.