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Fig. 1B —MR images of typical patient with Merkel cell carcinoma show
one unique imaging finding of Merkel cell carcinoma: positive anatomic
alignment of subcutaneous lymphatic tumor nodules. Patient is 63-year-old man
with primary tumor in skin of right popliteal fossa. Corresponding axial STIR
image (4,800/60; inversion time, 180 msec) shows high signal intensity of skin
and subcutaneous lymphatic metastases (small arrows), an example of
positive anatomic alignment of subcutaneous lymphatic tumor nodules. Marked
reticular stranding in subcutaneous fat is also seen. Histologically these two
findings were shown to represent lymphangitis carcinomatosa. Lymph node
metastases (large arrow) are seen adjacent to proximal superficial
femoral artery.
