{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T14:25:29Z","timestamp":1785680729787,"version":"3.56.0"},"reference-count":30,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,6]]},"abstract":"\n Context<\/jats:italic>\n .\u2014Inflammatory myofibroblastic tumor is a predominantly benign, spindle cell, mesenchymal neoplasm with myxoid areas that occurs rarely in the female genital tract and may be confused with other spindle cell lesions, particularly leiomyosarcoma.\n <\/jats:p>\n \n Objective<\/jats:italic>\n .\u2014To investigate the utility of detecting anaplastic lymphoma kinase-1 protein expression and\n ALK<\/jats:italic>\n gene rearrangements in the diagnosis of inflammatory myofibroblastic tumors in the female genital tract.\n <\/jats:p>\n \n Design<\/jats:italic>\n .\u2014Eight inflammatory myofibroblastic tumors arising in the female genital tract and seen in consultation (from 2004 to 2011) were reviewed. Immunohistochemistry for anaplastic lymphoma kinase-1 and fluorescence in-situ hybridization studies for\n ALK<\/jats:italic>\n gene rearrangements were performed.\n <\/jats:p>\n \n Results<\/jats:italic>\n .\u2014The anatomic sites included myometrium (4 cases) and endometrium, fallopian tube, cervix, and a cervical polyp (1 each), with a patient age range from 25 to 52\u00a0years. Histologic features ranged from bland spindle cells to striking cytologic atypia, embedded in a prominent myxoid background. Anaplastic lymphoma kinase-1 immunohistochemistry was positive in 7 cases. Fluorescence in-situ hybridization studies detected\n ALK<\/jats:italic>\n gene rearrangements in 5 cases. Five cases had both immunopositivity and fluorescence in-situ hybridization abnormalities, 2 cases had immunopositivity only, and 1 case was negative by both methods.\n <\/jats:p>\n \n Conclusions<\/jats:italic>\n .\u2014This is the first report, to our knowledge, of\n ALK<\/jats:italic>\n gene rearrangements in inflammatory myofibroblastic tumors in the female genital tract. If a myxoid background is appreciated in a spindle cell lesion of the female genital tract, especially if inflammatory cells are present, anaplastic lymphoma kinase-1 staining along with fluorescence in situ hybridization studies, for\n ALK<\/jats:italic>\n gene rearrangements, may aid in distinguishing inflammatory myofibroblastic tumors from their malignant mimics.\n <\/jats:p>","DOI":"10.5858\/arpa.2011-0341-oa","type":"journal-article","created":{"date-parts":[[2012,5,30]],"date-time":"2012-05-30T12:57:32Z","timestamp":1338382652000},"page":"623-626","source":"Crossref","is-referenced-by-count":55,"title":["ALK-1 Protein Expression and ALK Gene Rearrangements Aid in the Diagnosis of Inflammatory Myofibroblastic Tumors of the Female Genital Tract"],"prefix":"10.5858","volume":"136","author":[{"given":"Neil E.","family":"Fuehrer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary L.","family":"Keeney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhett P.","family":"Ketterling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan A.","family":"Knudson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra A.","family":"Bell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"issue":"6","key":"i1543-2165-136-6-623-b01","series-title":"Am J Surg Pathol","first-page":"535","article-title":"Problematic uterine smooth muscle neoplasms: a clinicopathologic study of 213 cases","volume":"18","author":"Bell\n SW,","year":"1994","unstructured":"Bell\n SW, \n \n Kempson\n RL, \n \n Hendrickson\n MR\n \n . Problematic uterine smooth muscle neoplasms: a clinicopathologic study of 213 cases. Am J Surg Pathol. 1994;18(6):535\u2013558."},{"issue":"1","key":"i1543-2165-136-6-623-b02","series-title":"Gynecol Oncol","first-page":"156","article-title":"Myxoid leiomyosarcoma of the uterus with unusual malignant histologic pattern\u2014a case report","volume":"59","author":"Schneider\n D,","year":"1995","unstructured":"Schneider\n D, \n \n Halperin\n R, \n \n Segal\n M, \n \n Maymon\n R, \n \n Bukovsky\n I\n \n . Myxoid leiomyosarcoma of the uterus with unusual malignant histologic pattern\u2014a case report. Gynecol Oncol. 1995;59(1):156\u2013158."},{"issue":"3","key":"i1543-2165-136-6-623-b03","series-title":"J Thorac Oncol","first-page":"459","article-title":"Correlation of IHC and FISH for ALK gene rearrangement in non\u2013small cell lung carcinoma: IHC score algorithm for FISH","volume":"6","author":"Yi\n ES,","year":"2011","unstructured":"Yi\n ES, \n \n Boland\n JM, \n \n Maleszewski\n JJ\n , et al. \n Correlation of IHC and FISH for ALK gene rearrangement in non\u2013small cell lung carcinoma: IHC score algorithm for FISH. J Thorac Oncol. 2011;6(3):459\u2013465."},{"issue":"6","key":"i1543-2165-136-6-623-b04","series-title":"Mod Pathol","first-page":"569","article-title":"ALK1 and p80 expression and chromosomal rearrangements involving 2p23 in inflammatory myofibroblastic tumor","volume":"14","author":"Coffin\n CM,","year":"2001","unstructured":"Coffin\n CM, \n \n Patel\n A, \n \n Perkins\n S, \n \n Elenitoba-Johnson\n KS, \n \n Perlman\n E, \n \n Griffin\n CA\n \n . ALK1 and p80 expression and chromosomal rearrangements involving 2p23 in inflammatory myofibroblastic tumor. Mod Pathol. 2001;14(6):569\u2013576."},{"issue":"3","key":"i1543-2165-136-6-623-b05","series-title":"Am J Obstet Gynecol","first-page":"890","article-title":"Inflammatory myoblastic tumor of the uterus and interleukin-6","volume":"189","author":"Azuno\n Y,","year":"2003","unstructured":"Azuno\n Y, \n \n Yaga\n K, \n \n Suehiro\n Y, \n \n Ariyama\n S, \n \n Oga\n A\n \n . Inflammatory myoblastic tumor of the uterus and interleukin-6. Am J Obstet Gynecol. 2003;189(3):890\u2013891."},{"issue":"6","key":"i1543-2165-136-6-623-b06","series-title":"Tumori","first-page":"454","article-title":"Inflammatory pseudotumor of the uterus: a case report","volume":"81","author":"Kargi\n HA,","year":"1995","unstructured":"Kargi\n HA, \n \n Ozer\n E, \n \n G\u00f6kden\n N\n \n . Inflammatory pseudotumor of the uterus: a case report. Tumori. 1995;81(6):454\u2013456."},{"issue":"10","key":"i1543-2165-136-6-623-b07","series-title":"Pathol Int","first-page":"625","article-title":"Inflammatory myofibroblastic tumor of the uterus with prominent myxoid change","volume":"56","author":"Shintaku\n M,","year":"2006","unstructured":"Shintaku\n M, \n \n Fukushima\n A\n \n . Inflammatory myofibroblastic tumor of the uterus with prominent myxoid change. Pathol Int. 2006;56(10):625\u2013628."},{"issue":"10","key":"i1543-2165-136-6-623-b08","series-title":"Am J Surg Pathol","first-page":"1348","article-title":"Inflammatory myofibroblastic tumor of the uterus: a clinicopathologic study of 6 cases emphasizing distinction from aggressive mesenchymal tumors","volume":"29","author":"Rabban\n JT,","year":"2005","unstructured":"Rabban\n JT, \n \n Zaloudek\n CJ, \n \n Shekitka\n KM, \n \n Tavassoli\n FA\n \n . 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Mod Pathol. 2007;20(5):592\u2013603."},{"issue":"6","key":"i1543-2165-136-6-623-b12","series-title":"Hum Pathol","first-page":"711","article-title":"Expression of anaplastic lymphoma kinase in soft tissue tumors: an immunohistochemical and molecular study of 249 cases","volume":"35","author":"Li\n XQ,","year":"2004","unstructured":"Li\n XQ, \n \n Hisaoka\n M, \n \n Shi\n DR, \n \n Zhu\n XZ, \n \n Hashimoto\n H\n \n . Expression of anaplastic lymphoma kinase in soft tissue tumors: an immunohistochemical and molecular study of 249 cases. Hum Pathol. 2004;35(6):711\u2013721."},{"issue":"4","key":"i1543-2165-136-6-623-b13","series-title":"Arch Pathol Lab Med","first-page":"595","article-title":"Smooth muscle tumors of the uterus: a practical approach","volume":"132","author":"Toledo\n G,","year":"2008","unstructured":"Toledo\n G, \n \n Oliva\n E\n \n . Smooth muscle tumors of the uterus: a practical approach. Arch Pathol Lab Med. 2008;132(4):595\u2013605."},{"issue":"5","key":"i1543-2165-136-6-623-b14","series-title":"Adv Anat Pathol","first-page":"257","article-title":"Endometrial stromal tumors: an update on a group of tumors with a protean phenotype","volume":"7","author":"Oliva\n E,","year":"2000","unstructured":"Oliva\n E, \n \n Clement\n PB, \n \n Young\n RH\n \n . Endometrial stromal tumors: an update on a group of tumors with a protean phenotype. Adv Anat Pathol. 2000;7(5):257\u2013281."},{"issue":"4","key":"i1543-2165-136-6-623-b15","series-title":"J Clin Pathol","first-page":"428","article-title":"Inflammatory myofibroblastic tumours: where are we now","volume":"61","author":"Gleason\n BC,","year":"2008","unstructured":"Gleason\n BC, \n \n Hornick\n JL\n \n . Inflammatory myofibroblastic tumours: where are we now? J Clin Pathol. 2008;61(4):428\u2013437."},{"issue":"6","key":"i1543-2165-136-6-623-b01","series-title":"Am J Surg Pathol","first-page":"535","article-title":"Problematic uterine smooth muscle neoplasms: a clinicopathologic study of 213 cases","volume":"18","author":"Bell\n SW,","year":"1994","unstructured":"Bell\n SW, \n \n Kempson\n RL, \n \n Hendrickson\n MR\n \n . Problematic uterine smooth muscle neoplasms: a clinicopathologic study of 213 cases. Am J Surg Pathol. 1994;18(6):535\u2013558."},{"issue":"1","key":"i1543-2165-136-6-623-b02","series-title":"Gynecol Oncol","first-page":"156","article-title":"Myxoid leiomyosarcoma of the uterus with unusual malignant histologic pattern\u2014a case report","volume":"59","author":"Schneider\n D,","year":"1995","unstructured":"Schneider\n D, \n \n Halperin\n R, \n \n Segal\n M, \n \n Maymon\n R, \n \n Bukovsky\n I\n \n . Myxoid leiomyosarcoma of the uterus with unusual malignant histologic pattern\u2014a case report. Gynecol Oncol. 1995;59(1):156\u2013158."},{"issue":"3","key":"i1543-2165-136-6-623-b03","series-title":"J Thorac Oncol","first-page":"459","article-title":"Correlation of IHC and FISH for ALK gene rearrangement in non\u2013small cell lung carcinoma: IHC score algorithm for FISH","volume":"6","author":"Yi\n ES,","year":"2011","unstructured":"Yi\n ES, \n \n Boland\n JM, \n \n Maleszewski\n JJ\n , et al. \n Correlation of IHC and FISH for ALK gene rearrangement in non\u2013small cell lung carcinoma: IHC score algorithm for FISH. J Thorac Oncol. 2011;6(3):459\u2013465."},{"issue":"6","key":"i1543-2165-136-6-623-b04","series-title":"Mod Pathol","first-page":"569","article-title":"ALK1 and p80 expression and chromosomal rearrangements involving 2p23 in inflammatory myofibroblastic tumor","volume":"14","author":"Coffin\n CM,","year":"2001","unstructured":"Coffin\n CM, \n \n Patel\n A, \n \n Perkins\n S, \n \n Elenitoba-Johnson\n KS, \n \n Perlman\n E, \n \n Griffin\n CA\n \n . ALK1 and p80 expression and chromosomal rearrangements involving 2p23 in inflammatory myofibroblastic tumor. Mod Pathol. 2001;14(6):569\u2013576."},{"issue":"3","key":"i1543-2165-136-6-623-b05","series-title":"Am J Obstet Gynecol","first-page":"890","article-title":"Inflammatory myoblastic tumor of the uterus and interleukin-6","volume":"189","author":"Azuno\n Y,","year":"2003","unstructured":"Azuno\n Y, \n \n Yaga\n K, \n \n Suehiro\n Y, \n \n Ariyama\n S, \n \n Oga\n A\n \n . Inflammatory myoblastic tumor of the uterus and interleukin-6. Am J Obstet Gynecol. 2003;189(3):890\u2013891."},{"issue":"6","key":"i1543-2165-136-6-623-b06","series-title":"Tumori","first-page":"454","article-title":"Inflammatory pseudotumor of the uterus: a case report","volume":"81","author":"Kargi\n HA,","year":"1995","unstructured":"Kargi\n HA, \n \n Ozer\n E, \n \n G\u00f6kden\n N\n \n . Inflammatory pseudotumor of the uterus: a case report. Tumori. 1995;81(6):454\u2013456."},{"issue":"10","key":"i1543-2165-136-6-623-b07","series-title":"Pathol Int","first-page":"625","article-title":"Inflammatory myofibroblastic tumor of the uterus with prominent myxoid change","volume":"56","author":"Shintaku\n M,","year":"2006","unstructured":"Shintaku\n M, \n \n Fukushima\n A\n \n . Inflammatory myofibroblastic tumor of the uterus with prominent myxoid change. Pathol Int. 2006;56(10):625\u2013628."},{"issue":"10","key":"i1543-2165-136-6-623-b08","series-title":"Am J Surg Pathol","first-page":"1348","article-title":"Inflammatory myofibroblastic tumor of the uterus: a clinicopathologic study of 6 cases emphasizing distinction from aggressive mesenchymal tumors","volume":"29","author":"Rabban\n JT,","year":"2005","unstructured":"Rabban\n JT, \n \n Zaloudek\n CJ, \n \n Shekitka\n KM, \n \n Tavassoli\n FA\n \n . Inflammatory myofibroblastic tumor of the uterus: a clinicopathologic study of 6 cases emphasizing distinction from aggressive mesenchymal tumors. Am J Surg Pathol. 2005;29(10):1348\u20131355."},{"issue":"11","key":"i1543-2165-136-6-623-b09","series-title":"Am J Surg Pathol","first-page":"1364","article-title":"Anaplastic lymphoma kinase (ALK) expression in the inflammatory myofibroblastic tumor: a comparative immunohistochemical study","volume":"25","author":"Cook\n JR,","year":"2001","unstructured":"Cook\n JR, \n \n Dehner\n LP, \n \n Collins\n MH\n , et al. \n Anaplastic lymphoma kinase (ALK) expression in the inflammatory myofibroblastic tumor: a comparative immunohistochemical study. Am J Surg Pathol. 2001;25(11):1364\u20131371."},{"issue":"12","key":"i1543-2165-136-6-623-b10","series-title":"Am J Surg Pathol","first-page":"1609","article-title":"ALK-1 expression in inflammatory myofibroblastic tumor of the urinary bladder","volume":"28","author":"Tsuzuki\n T,","year":"2004","unstructured":"Tsuzuki\n T, \n \n Magi-Galluzzi\n C, \n \n Epstein\n JI\n \n . ALK-1 expression in inflammatory myofibroblastic tumor of the urinary bladder. Am J Surg Pathol. 2004;28(12):1609\u20131614."},{"issue":"5","key":"i1543-2165-136-6-623-b11","series-title":"Mod Pathol","first-page":"592","article-title":"Utility of ALK-1 protein expression and ALK rearrangements in distinguishing inflammatory myofibroblastic tumor from malignant spindle cell lesions of the urinary bladder","volume":"20","author":"Sukov\n WR,","year":"2007","unstructured":"Sukov\n WR, \n \n Cheville\n JC, \n \n Carlson\n AW\n , et al. \n Utility of ALK-1 protein expression and ALK rearrangements in distinguishing inflammatory myofibroblastic tumor from malignant spindle cell lesions of the urinary bladder. Mod Pathol. 2007;20(5):592\u2013603."},{"issue":"6","key":"i1543-2165-136-6-623-b12","series-title":"Hum Pathol","first-page":"711","article-title":"Expression of anaplastic lymphoma kinase in soft tissue tumors: an immunohistochemical and molecular study of 249 cases","volume":"35","author":"Li\n XQ,","year":"2004","unstructured":"Li\n XQ, \n \n Hisaoka\n M, \n \n Shi\n DR, \n \n Zhu\n XZ, \n \n Hashimoto\n H\n \n . Expression of anaplastic lymphoma kinase in soft tissue tumors: an immunohistochemical and molecular study of 249 cases. Hum Pathol. 2004;35(6):711\u2013721."},{"issue":"4","key":"i1543-2165-136-6-623-b13","series-title":"Arch Pathol Lab Med","first-page":"595","article-title":"Smooth muscle tumors of the uterus: a practical approach","volume":"132","author":"Toledo\n G,","year":"2008","unstructured":"Toledo\n G, \n \n Oliva\n E\n \n . Smooth muscle tumors of the uterus: a practical approach. Arch Pathol Lab Med. 2008;132(4):595\u2013605."},{"issue":"5","key":"i1543-2165-136-6-623-b14","series-title":"Adv Anat Pathol","first-page":"257","article-title":"Endometrial stromal tumors: an update on a group of tumors with a protean phenotype","volume":"7","author":"Oliva\n E,","year":"2000","unstructured":"Oliva\n E, \n \n Clement\n PB, \n \n Young\n RH\n \n . Endometrial stromal tumors: an update on a group of tumors with a protean phenotype. Adv Anat Pathol. 2000;7(5):257\u2013281."},{"issue":"4","key":"i1543-2165-136-6-623-b15","series-title":"J Clin Pathol","first-page":"428","article-title":"Inflammatory myofibroblastic tumours: where are we now","volume":"61","author":"Gleason\n BC,","year":"2008","unstructured":"Gleason\n BC, \n \n Hornick\n JL\n \n . Inflammatory myofibroblastic tumours: where are we now? 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