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Myxoinflammatory Fibroblastic Sarcoma: MR Appearance and Pathologic Correlation

Ukihide Tateishi1, Tadashi Hasegawa2, Hiroaki Onaya1, Mitsuo Satake1, Yasuaki Arai1 and Noriyuki Moriyama1

1 Division of Diagnostic Radiology, National Cancer Center Hospital and Institute, Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan.
2 Pathology Division, National Cancer Center Hospital and Institute, Tsukiji, Tokyo, Japan.



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  		Fig. 1A. —Myxoinflammatory fibroblastic sarcoma in 62-year-old man with painless mass in finger. Sagittal T1-weighted MR image (TR/TE, 450/15) shows poorly circumscribed mass beneath tendon sheath of flexor hallucis longus (arrows).

 


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  		Fig. 1B. —Myxoinflammatory fibroblastic sarcoma in 62-year-old man with painless mass in finger. Sagittal contrast-enhanced T1-weighted MR image (450/15) shows homogeneous enhancement (arrows).

 


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  		Fig. 1C. —Myxoinflammatory fibroblastic sarcoma in 62-year-old man with painless mass in finger. Photograph of histopathologic specimen shows solid nests of spindle and epithelioid tumor cells with foci of inflammatory cell infiltrate (arrows).

 


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  		Fig. 2A. —Myxoinflammatory fibroblastic sarcoma in 31-year-old man with painless mass in subcutaneous soft tissue of wrist. Coronal contrast-enhanced T1-weighted MR image (TR/TE, 520/15) shows poorly circumscribed mass with ill-defined border. Tumor involves surrounding tendon sheath diffusely and focally infiltrates dermis (arrow).

 


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  		Fig. 2B. —Myxoinflammatory fibroblastic sarcoma in 31-year-old man with painless mass in subcutaneous soft tissue of wrist. Axial contrast-enhanced T1-weighted MR image (520/15) shows mass involving ulnar nerve (arrow) and tendon sheath of flexor carpi ulnaris (arrowhead).

 


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  		Fig. 2C. —Myxoinflammatory fibroblastic sarcoma in 31-year-old man with painless mass in subcutaneous soft tissue of wrist. Photograph of histopathologic specimen reveals that numerous small nodules consisting of tumor cells infiltrate along ulnar nerve (arrows).

 


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  		Fig. 3A. —Myxoinflammatory fibroblastic sarcoma in foot of 32-year-old woman with local recurrence. Sagittal T2-weighted MR image (TR/TE, 3,600/120) shows mass of sheetlike appearance beneath dorsal portion of tendon sheath. Tumor shows intermediate signal intensity, greater than that of muscle (arrow).

 


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  		Fig. 3B. —Myxoinflammatory fibroblastic sarcoma in foot of 32-year-old woman with local recurrence. Sagittal contrast-enhanced fat-saturated T1-weighted MR image (520/15) shows homogeneous enhancement of tumor (arrows).

 


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  		Fig. 3C. —Myxoinflammatory fibroblastic sarcoma in foot of 32-year-old woman with local recurrence. Photograph of histopathologic specimen shows sheetlike proliferation of spindle-shaped tumor cells (arrows) with ganglionlike cells, Reed-Sternberg-like cells, and lymphoid cells surrounding tendon sheaths.

 


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  		Fig. 4A. —Myxoinflammatory fibroblastic sarcoma in foot of 24-year-old man with local recurrence. Coronal fat-saturated T2-weighted MR image (TR/TE, 3,500/105) shows mass of branching pattern that occurred along extensor digitorum longus tendon sheaths of second and fourth toes (arrows). Tumor shows intermediate signal intensity, greater than that of muscle.

 


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  		Fig. 4B. —Myxoinflammatory fibroblastic sarcoma in foot of 24-year-old man with local recurrence. Coronal contrast-enhanced T1-weighted MR image (520/15) shows heterogeneous enhancement of tumor (arrows).

 


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  		Fig. 4C. —Myxoinflammatory fibroblastic sarcoma in foot of 24-year-old man with local recurrence. Photograph of histopathologic specimens shows proliferation of spindle-shaped tumor cells (arrows) with prominent nucleoli in abundant myxoid stromal matrix.

 

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