Recent evidence reveals the presence of anaplastic lymphoma kinase (ALK) gene rearrangements and expression in IMTs {486,949,1440,2865}. These rearrangements are common in IMTs of children and young adults {949,1440,2486} and are uncommon over the age of 40 {367,486,1440}. Both the gene rearrangements and protein activation are restricted to the myofibroblastic component, while the inflammatory cell component is normal {270,466,466,486,486, 949,1440}. Fusion of ALK to Ran-binding protein 2 gene in IMTs expand the spectrum of ALK abnormalities seen in IMT further confirming the clonal, neoplastic nature of IMTs {1593}.

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