Overview
Plasma cell granuloma, also known as inflammatory myofibroblastic tumor, is a rare benign lesion typically found as an intrapulmonary mass, predominantly in pediatric patients. It can rarely occur in atypical locations such as the heart, presenting as an asymptomatic mass that may spontaneously regress 1.Diagnosis
Clinical Presentation: Often asymptomatic intrapulmonary mass in children; can present as an asymptomatic cardiac mass in rare cases 1.
Imaging: Chest CT or MRI typically reveals a well-defined mass with characteristic features 1.
Histopathology: Definitive diagnosis requires histopathological examination showing plasma cells and inflammatory cells 1.
Immunohistochemistry: Positive staining for anaplastic lymphoma kinase (ALK) in some cases can aid in diagnosis 1.Management
Surgical Excision: First-line treatment for resectable lesions, often curative 1.
Observation: For unresectable or spontaneously regressing masses, close monitoring without immediate intervention may be appropriate 1.
No Specific Medical Therapy: No pharmacological treatment is typically required unless complications arise 1.Special Populations
Pediatrics: Most commonly affects children, with surgical excision being curative 1.
Atypical Locations: Cardiac involvement is rare but should be considered in differential diagnosis; spontaneous regression can occur 1.Key Recommendations
Consider plasma cell granuloma in the differential diagnosis of pediatric cardiac masses, given potential for spontaneous regression 1 (Evidence: Expert opinion).
Surgical excision is recommended for resectable intrapulmonary plasma cell granulomas due to its curative potential 1 (Evidence: Expert opinion).
For unresectable or asymptomatic cases, particularly in atypical locations like the heart, observation may be a reasonable management strategy 1 (Evidence: Weak).References
1 Pearson PJ, Smithson WA, Driscoll DJ, Banks PM, Ehman RL. Inoperable plasma cell granuloma of the heart: spontaneous decrease in size during an 11-month period. Mayo Clinic proceedings 1988. link64918-0)