Journal of Korean Society of Medical Ultrasound 1999;18(3): 221-226.
US Findings of Neurilemmoma of the Extremities: Pathologic Correlation.
Jong O Choi, Jae Hong An, Kil Ho Cho, Bok Hwan Park, Mi Soo Hwang, Jae Kyo Lee, Dong Sug Kim
1Department of Diagnostic Radiology, College of Medicine, Yeungnam University Taegu, Korea.
2Department of Pathology, College of Medicine, Yeungnam University Taegu, Korea.
  Published online: January 1, 2001.
PURPOSE: To describe the sonographic features of peripheral neurilemmomas and to compare them with histopathologic findings. MATERIALS and METHODS: Ten cases of the neurilemmoma confirmed by pathology were evaluated, retropectively. We analyzed the size, shape, margin, echogenicity, homogeneity, the existence of peripheral nerves, and the distribution of vascularity of five cases with a color-coded Doppler study. We compared sonographic features with the pathologic findings including gross and microscopic features. RESULTS: The tumors were round and oval shaped, and all tumors showed low echogenic mass with posterior enhancement and distinct margins. The arising nerve was found in five cases. Seven cases showed inhomogeneous echogenicity. All of 5 cases showed vascularity on echogenic area or boundary portion between the hyperechoic and hypoechoic area of the mass on the color-coded Doppler study. Some areas of hemorrhage and myxoid degeneration were described in seven cases on pathologic paper. On microscopy, all specimen were composed of cellular Antoni A tissue and myxoid Antoni B tissue, and more larger specimen showed several cystic degeneration and hemorrhagic foci in the mass. It was difficult to correlate the exact foci on microscopic feature with sonographic feature due to unclear the section slice. CONCLUSION: Sonographic characteristics of peripheral neurilemmoma include low echogenicity, posterior enhancement, distinct margin, inhomogeneous internal echo, and suspended nerve strings. Inhomogeneous internal echo may be attributed to the variable cellularity, cystic change, and focal hemorrhage of the tumors.
Keywords: Extremities US; Soft tissues neoplasms; Neurilemmoma US
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