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| Imaging features and relevant pathological changes of myxofibrosarcoma |
| WANG Wei-wei, ZHAO Fan, CHEN Yue-qin |
| Department of Imaging, Affiliated Hospital of Jining Medical University, Jining Shandong 272029, China |
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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.
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Received: 30 November 2018
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