Imaging Findings in Desmoplastic Fibroma of Bone: Distinctive T2 Characteristics
Matthew A. Frick1,
Murali Sundaram1,2,
Krishnan K. Unni3,
Carrie Y. Inwards3,
Nicola Fabbri4,
Federico Trentani4,
Patrizia Baccini5 and
Franco Bertoni5
1 Department of Radiology, Mayo Clinic, West-2, 200 First Street, SW, Rochester,
MN 55905.
3 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester,
Minnesota.
4 Servizio di Ortopedico, Istituto Ortopedico Rizzoli, Bologna, Italy.
5 Servizio di Anatomia e Istologia Patologica, Istituto Ortopedico Rizzoli,
Bologna, Italy.
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Fig. 1. —Anteroposterior radiograph of pelvis of 30-year-old man shows
well-marginated, nonsclerotic, osteolytic lesion (white box) of left
superior pelvis that extends into left superior pubic ramus abutting pubic
symphysis. A few thin, internal bony ridges are present.
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Fig. 2. —Lateral radiograph of right forearm of 75-year-old man shows
long, well-marginated, unmineralized, ulnar diaphyseal lesion with associated
endosteal scalloping. Lesion has no significant trabeculations.
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Fig. 3. — Anteroposterior (A) and lateral (B)
radiographs of distal right femur in 30-year-old man show large eccentric
lesion in femur that, unlike in Figs.
1 and
2, reveal markedly coarse
trabeculations within lesion and cortical breaching posterolaterally.
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Fig. 4. —Anteroposterior (A) and lateral (B) radiographs
of upper lumbar spine in 24-year-old man show well-defined osteolytic lesion
of L2 vertebra with extension into pedicle. A few thin, internal trabeculae
also are present.
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Fig. 4C. Unenhanced axial CT of same patient shows predominately osteolytic lesion
with mild central sclerosis and cortical breaching.
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Fig. 5. —T1-weighted MR image (TR/TE, 460/50) of 30-year-old man also
shown in Fig. 1 shows lesion in
pelvis is isointense with muscle and entirely intracompartmental.
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Fig. 6. —Axial T1-weighted image (TR/TE, 700/16) of ulnar diaphysis in
75-year-old man also shown in Figs.
2 and
8 shows lesion is isointense
to muscle.
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Fig. 7. —Coronal PD-weighted image (TR/TE, 4,560/39) image of
30-year-old man also shown in Figs.
1 and
5. More than 75% of lesion has
T2 shortening, making it virtually indistinguishable from surrounding muscle.
Peripheral signal intensity is high.
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Fig. 8 —Axial T2-weighted MR image (TR/TE, 2,000/80) of right ulna of
75-year-old man also shown in Figs.
2 and
6 shows more than 75% T2
shortening of long, osteolytic lesion.
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Fig. 9. —Sagittal T2-weighted image (TR/TE, 2,000/80) of lumbar spine
of 24-year-old man also shown in Figs.
4A,
4B, and
4C shows T2 shortening of
almost entire lesion. Entire involved vertebral body is slightly lower in
signal intensity than surrounding normal vertebral bodies.
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Fig. 10. —42-year-old man with vertebral lesion that had been
percutaneously biopsied. Histologic differential diagnosis was fibrous
dysplasia versus desmoplastic fibroma. Axial T2-weighted image (TR/TE,
4,000/88) shows more than 90% of lesion is hypointense to muscle, favoring
diagnosis of desmoplastic fibroma.
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Fig. 11. — Axial T2-weighted image (TR/TE, 5,300/117) of calcaneus in
28-year-old man shows lesion with more than 75% T2 shortening with minimal
high signal at anterior peripheral margin.
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Copyright © 2005 by the American Roentgen Ray Society.
