Abstract：Objective: To investigate MRI and relevant pathological features of myxofibrosarcoma(MFS). Methods: The MRI findings and pathological results of 16 cases with MFS proved by pathology were retrospectively analyzed. Eight cases were low-grade, 2 cases were intermediate-grade, and 6 cases were high-grade. Results: Fourteen cases were located under the superficial fascia, 2 cases were located in the muscular space, 7 cases were round shapes, 6 cases were spindle shapes, and 3 cases were irregular shapes. The tumors ranged from 4.6~13.2 cm in maximum diameter, with an average of 7.6 cm. On T1WI, 2 cases showed slightly hyper-intensity, 14 cases were heterogeneous with signal intensity similar or lower than that of muscles, 2 cases showed uniform high signal intensity on T2WI, 14 cases demonstrated mixed high signal intensity, 11 cases showed mixed high signal intensity on DWI and hypo-intensity signal on ADC, 10 cases presented heterogeneous enhancement. Fifteen cases showed “fascia tail signs”, 12 cases had peritumoral edema, 12 showed “double low signal signs”, 11 cases demonstrated cysts and necrosis, 6 cases showed mucoid degeneration. The difference of ADC value between 6 cases with cystic and necrotic and 5 cases with mucoid degeneration was statistically significant(P＜0.05). Tumor size, “double low signal signs” and “tail signs” were not significantly different between low-grade group and intermediate-high-grade group(P＞0.05). There were significant differences for peritumoral edema, cystic necrosis and mucoid degeneration between the two groups(P＜0.05). Microscopically, the mucoid matrix was rich in loose area with curved blood vessels around it. Multiple spindle tumor cells could be seen in dense areas of cells. The heterogeneity was obvious, and mitosis was more common. Immunohistochemically, all 16 cases were positive for vimentin, 13 cases were positive for CD34. Conclusion: MFS has certain MRI characteristics which is helpful to improve the diagnostic accuracy, the final diagnosis still depends on pathology.
王唯伟，赵 凡，陈月芹. 黏液纤维肉瘤的MRI表现及其病理学基础[J]. 中国临床医学影像杂志, 2019, 30(11): 807-811.
WANG Wei-wei, ZHAO Fan, CHEN Yue-qin. Imaging features and relevant pathological changes of myxofibrosarcoma. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(11): 807-811.
[1]Neagu TP, Sinescu RD, Enache V, et al. Metastatic high-grade myxofibrosarcoma: review of a clinical case[J]. Rom J Morphol Embryol, 2017, 58(2): 603-609.
[2]Kikuta K, Kubota D, Yoshida A, et al. An analysis of factors related to the tail-like pattern of myxofibrosarcoma seen on MRI[J]. Skeletal Radiol, 2015, 44(1): 55-62.
[3]Fletcher CDM, Bridge JA, Hogendoom PCW, et al. WHO classification of tumors of soft tissue and bone[M]. 4th ed. Lyon: IARC, 2013: 93-94.
[4]De Castro BA, Piancastelli AC, Meyer RL, et al. Myxofibrosarcoma—Case report[J]. An Bras Dermatol, 2016, 91(1): 97-99.
[5]何珏，王天科，韩巧秀. 黏液纤维肉瘤临床病理观察[J]. 中华肿瘤防治杂志，2015，22（15）：1235-1239.
[6]李培岭，刘玉珂，赵颖，等. 四肢软组织原发黏液性纤维肉瘤的MRI表现[J]. 实用放射学杂志，2017，33（11）：1728-1731.
[7]张慧红，乐洪波，吴先衡，等. 粘液样软组织肿瘤的CT和MRI表现特征[J]. 中华放射学杂志，2015，49（12）：883-888.
[8]马小龙，汪建华，陆建平，等. 黏液纤维肉瘤的MRI表现与组织病理学对照[J]. 放射学实践，2011，22（2）：216-219.
[9]林达，黄晓辉，余捷，等. 软组织黏液样纤维肉瘤的病理及MRI表现[J]. 实用放射学杂志，2018，34（3）：411-414.
[10]Lefkowitz RA, Landa J, Hwang S, et al. Myxofibrosarcoma: prevalence and diagnostic value of the “tail sign” on magnetic resonance imaging[J]. Skeletal Radiol, 2013, 42(6): 809-818.
[11]Yoo HJ, Hong SH, Kang Y, et al. MR imaging of myxofibrosarcoma and undifferentiated sarcoma with emphasis on tail sign; diagnostic and prognostic value[J]. Eur Radiol, 2014, 24(8): 1749-1757.
[12]Kikuta K, Kubota D, Yoshida A, et al. An analysis of factors related to the tail-like pattern of myxofibrosarcoma seen on MRI[J]. Skeletal Radiol, 2015, 44(1): 55-62.
[13]侯美蓉，谭相良，严承功，等. 低度恶性纤维黏液样肉瘤的CT和MRI表现[J]. 中华放射学杂志，2015，49（12）：941-943.
[14]乐洪波，张慧红，吴先衡，等. 肌内黏液瘤的MRI表现及病理对照分析[J]. 中华放射学杂志，2016，50（1）：64-67.
[15]李娴，孙新海，朱来敏，等. 多形性未分化肉瘤的MR表现[J]. 医学影像学杂志，2014，24（8）：1354-1357.
