CT features and pathological analysis of mesenteric inflammatory myofibroblastoma in children

MA Lu; WANG Pange; CHEN Xiaoyun; ZHENG Bin; SHI Shengli

doi:10.20258/j.cnki.1006-9011.2026.01.029

Abstract：Objective The CT and pathological features of mesenteric inflammatory myofibroblastoma(IMT)in children were analyzed to improve its diagnosis.Methods The clinical data and CT findings of 9 children with mesenteric IMT con-firmed by surgery and pathology were selected.Results In 9 children,there were 8 cases with solitary lesions and 1 case with multiple lesions.The maximum diameter of the tumor ranged from 5.0 to 11.1 cm.On plain scan CT,the lesions were lobed in 8 cases,and heterogeneous solid density in 7 cases.The lesions all showed asymptotic enhancement,with 8 cases showing signifi-cant enhancement;1 case showed mostly cystic degeneration and the remaining solid part showed mild to moderate enhancement.In the arterial phase,8 lesions were supplied by mesenteric arteries,and the"umbilical concave sign","vascular pedicle sign",and focal nodular obvious enhancement were observed.6 cases showed spoke wheel-like enhancement from the center to the pe-riphery.There were enlarged mesenteric lymph nodes in 8 cases,and unclear boundaries in 5 cases.Histologically,the tumor consisted of differentiated myofibroblastic spindle cells with interstitial inflammatory cell infiltration.Immunohistochemistry showed that 8 cases were SMA(+),7 cases were Vimentin(+),and 7 cases wereALK(+).Conclusion The features of IMT enhancement,such as progressive enhancement pattern,the umbilical concave sign,vascular pedicle sign,and obvious focal enhancement,combined with immunomarkers can effectively differentiate from other mesenteric tumors.