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Fig. 3.54 Inflammatory myofibroblastic tumour. A Laryngeal IMTs show varied growth patterns including fascicular patterns. B The myofibroblasts appear spindle-shaped with enlarged round to oblong nuclei, inapparent to prominent eosinophilic nucleoli and abundant eosinophilic to basophilic appearing fibrillar cytoplasm. C In some examples, the myofibroblasts have a more epithelioid or histiocytoid appearance, including round to oval nuclei, prominent nucleoli and ample amount of cytoplasm. D The myofibroblasts may also appear as slender axonal (spider-like) cells with elongated nuclei, inapparent nucleoli and long cytoplasmic extensions, creating cells with a bipolar-to-multipolar (tadpole-like) appearance. E Scattered myofibroblasts show the presence of eosinophilic intranuclear inclusions (arrow). F The myofibroblasts in IMT show immunoreactivity for muscle specific actin.

Fig. 3.54 Inflammatory myofibroblastic tumour. A Laryngeal IMTs show varied growth patterns including fascicular patterns. B The myofibroblasts appear spindle-shaped with enlarged round to oblong nuclei, inapparent to prominent eosinophilic nucleoli and abundant eosinophilic to basophilic appearing fibrillar cytoplasm. C In some examples, the myofibroblasts have a more epithelioid or histiocytoid appearance, including round to oval nuclei, prominent nucleoli and ample amount of cytoplasm. D The myofibroblasts may also appear as slender axonal (spider-like) cells with elongated nuclei, inapparent nucleoli and long cytoplasmic extensions, creating cells with a bipolar-to-multipolar (tadpole-like) appearance. E Scattered myofibroblasts show the presence of eosinophilic intranuclear inclusions (arrow). F The myofibroblasts in IMT show immunoreactivity for muscle specific actin.

creating a tadpole-like appearance. The myofibroblasts invariably maintain a low nuclear-to-cytoplasmic ratio. Focal nuclear pleomorphism may be present. Mitoses are common, sometimes even numerous, but never atypical. Necrosis and marked nuclear pleomorphism are not seen.

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