To the Editors:
Inflammatory myofibroblastic tumour (IMT) is a relatively uncommon lesion and occurs in nearly every site of the body. Patients with IMT are usually asymptomatic, with a solitary nodule or mass detected by routine chest radiograph 1. Many diagnostic procedures can be applied to make the diagnosis: computed tomography (CT) scan to outline nodule growth and perfusion, [18F]-2-fluoro-deoxy-D-glucose (FDG)-PET/CT scan to evaluate metabolic activity and 111In-Diethylene triamine pentaacetic acid (DTPA)-D-Phe1 scan (octreoscan) to investigate somatostatin analogue receptors, often present in a variety of neuroendocrine tumours (NETs).
We present two cases of pulmonary IMT clinically misdiagnosed as carcinoid tumours due to a positive octreoscan.
Case 1 was a 52-yr-old female former smoker who was admitted to our hospital with thoracic pain. The electrocardiogram was completely negative for angina or myocardial infarction. Chest radiograph and CT revealed a left hilar nodule, sharply circumscribed, slightly lobulated, with a mild homogeneous increase of density after enhancement. A whole-body FDG-PET/CT scan showed increased tracer uptake of the lung mass (standardised uptake value (SUV) 25) compatible with a malignant lesion. SUVmax was calculated 50 min after injection and normalised for body weight. After intravenous administration of 111 mBq of [111In]-octreotide, an abnormal, although low, uptake was present in the left lung hilar region (fig. 1a⇓). Bronchoscopy was negative. On the basis of the CT, FDG-PET/CT and octreoscan, a clinical/radiological diagnosis of a carcinoid tumour, most probably atypical, was postulated. The intraoperative frozen specimen excluded the diagnosis of …
