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Sonographic Characteristics of Peripheral Nerve Sheath Tumors

David L. Reynolds, Jr.1, Jon A. Jacobson1, Prasuna Inampudi1, David A. Jamadar1, Farhad S. Ebrahim1 and Curtis W. Hayes1,2

1 Department of Radiology, University of Michigan Medical Center, 1500 E Medical Center Dr., TC 2910G, Ann Arbor, MI 48109-0326.
2 Present address: Department of Radiology, Medical College of Virginia, Virginia Commonwealth University, PO Box 980615, Richmond, VA 23298-0615.



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  		Fig. 1. —39-year-old man with ankle schwannoma. Sonogram over lateral ankle shows well-defined and hypoechoic schwannoma (arrow) with posterior acoustic enhancement (arrowheads). Horizontal linear echoes in mass represent artifacts. F = fibula.

 


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  		Fig. 2. —35-year-old man with schwannoma of posterior tibial nerve. Sonogram of posteromedial ankle shows well-defined and hypoechoic schwannoma (curved arrow). Note eccentric location of schwannoma relative to posterior tibial nerve (straight arrows) and posterior acoustic enhancement (arrowheads). Horizontal linear echoes in mass represent artifacts. FHL = flexor hallucis longus tendon.

 


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  		Fig. 3. —75-year-old man with schwannoma of dorsal cutaneous branch of superficial peroneal nerve. Sonogram of anterolateral ankle shows well-defined schwannoma with peripheral hypoechogenicity and central hyperechogenicity (curved arrow). Note direct and central continuity with dorsal cutaneous branch (straight arrows) of superficial peroneal nerve and posterior acoustic enhancement (arrowheads). F = fibula.

 


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  		Fig. 4 —19-year-old man with neurofibromatosis and plexiform neurofibroma of sciatic nerve. Sonogram of posterior thigh shows diffuse and lobular enlargement of sciatic nerve bundles (straight arrows). Note heterogeneous echotexture—several areas displaying target appearance of central hyperechogenicity and peripheral hypoechogenicity (curved arrow)—and areas of shadowing.

 


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  		Fig. 5. —22-year-old man with malignant peripheral nerve sheath tumor. Sonogram of posterior thigh shows mixed-echogenicity mass (straight arrows) with anechoic areas (curved arrow) and posterior acoustic enhancement (arrowheads).

 


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  		Fig. 6. —54-year-old woman with schwannoma of lateral branch of deep peroneal nerve. Color Doppler sonogram of dorsal ankle shows well-defined schwannoma with increased flow (arrow).

 

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