Article

Nodular fascitis in the thigh followed up using ultrasonography

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Abstract

A 41-year-old woman noticed a mass on the inside of her right thigh in April 2003. Ultrasound examination revealed a mass measuring 18 mm × 10 mm × 10 mm in the subcutaneous fatty tissues. Its boundary was relatively clear, with rough edges. The interior of the lesion was hyperechoic and contained an irregular hypoechoic area in its center; a color Doppler sonographic examination detected no blood flow signals. Incision biopsy examination seemed warranted. Pathologically, the specimen showed a proliferation of fibroblast-like spindle-shaped cells but no atypical cells. Immunologic staining revealed that sections were positive to vimentin; negative to CD34, CD68, α-smooth muscle actin (α-SMA), and S-100 protein; and mildly positive to HHF35. These results led to a diagnosis of nodular fascitis. Nodular fascitis is not common, and few studies have described its sonographic characteristics. We therefore used ultrasound to follow up the patient and found that the lesion was markedly smaller 3 months after the first examination, at which time it was hardly discernible as a mass. Here we compare the ultrasound and pathologic findings, and report the results of a bibliographic study.

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... On gray-scale US, a few reports [3] have described the lesion as irregular or lobulated margin and hypoechogenicity. There are also some reports [3,[5][6][7][8] concerning the imaging features on color Doppler US. The high-resolution ultrasonography (US) is a valuable tool that the discrepancies of imaging feature between intradermal and subcutaneous cases [9]. ...
... They noted pain at the site of the mass. One patient noted pain in the thigh and she incidentally found mass (case 2) [6]. The size of the incision-biopsied NF was found to greatly diminish to a mere shadow and no longer recognizable mass by follow-up US examination as previously described (case 2) [6]. ...
... One patient noted pain in the thigh and she incidentally found mass (case 2) [6]. The size of the incision-biopsied NF was found to greatly diminish to a mere shadow and no longer recognizable mass by follow-up US examination as previously described (case 2) [6]. The mean time to presentation of the 3 patients was 1 month. ...
... On gray-scale US, a few reports [3] have described the lesion as irregular or lobulated margin and hypoechogenicity. There are also some reports [3,[5][6][7][8] concerning the imaging features on color Doppler US. The high-resolution ultrasonography (US) is a valuable tool that the discrepancies of imaging feature between intradermal and subcutaneous cases [9]. ...
... They noted pain at the site of the mass. One patient noted pain in the thigh and she incidentally found mass (case 2) [6]. The size of the incision-biopsied NF was found to greatly diminish to a mere shadow and no longer recognizable mass by follow-up US examination as previously described (case 2) [6]. ...
... One patient noted pain in the thigh and she incidentally found mass (case 2) [6]. The size of the incision-biopsied NF was found to greatly diminish to a mere shadow and no longer recognizable mass by follow-up US examination as previously described (case 2) [6]. The mean time to presentation of the 3 patients was 1 month. ...
... To study the characteristic ultrasonographic features of NF will help to establish preoperative diagnostic criteria and to avoid unnecessary operation. We have reported a case of subcutaneous NF and reviewed the differences between intradermal and subcutaneous types on US including present case and previous two cases [1,2]. The usefulness of high-resolution US has enabled the differences of US findings between intradermal and subcutaneous lesions. ...
... subcutaneous and intradermal NFs [1,2]. gray-scale US were detected. ...
... Recently, the study using the ultra-highfrequency ultrasound in the evaluation of pediatric pilomatricoma has been reported [11]. The author usually performs US studies for dermatologic fields with a high-resolution, broad-band (5MHz-18MHz) linear transducer (Nobulus Hitachi, Ltd.Tokyo, Japan) and described several reports in the dermatologic area [2,4,5,[12][13][14][15][16][17][18][19][20][21][22][23][24]. ...
... a high-resolution, broad-band (5MHz-18MHz) linear transducer (Nobulus Hitachi, Ltd.Tokyo, Japan) and described knowledge including ALM reports and several studies in the dermatologic area [2,4,[10][11][12][13][14][15][16][17][18][19][20]. ...
... The author usually performs US studies for dermatologic fields with a high-resolution, broad-band (5MHz-18MHz) linear transducer (Nobulus Hitachi, Ltd. Tokyo, Japan) and described several studies including schwannoma [4][5][6][11][12][13][14][15][16][17][18][19][20][21][22]. ...
... Tokyo, Japan). We have also reported several studies of the dermatologic field [6][7][8][9][12][13][14][15][16][17][18]. Carra et al. [19] technically suggested that only light pressure should be used to avoid compressing small vessels and missing flow. ...
... We usually perform US studies for dermatologic fields with a high-resolution, broad-band (5MHz-18MHz) linear transducer (Nobulus Hitachi, Ltd.Tokyo, Japan). We have also provided several reports of the dermatologic lesion [6][7][8][9][10][11][12][13][14][15]. While, Carra et al. [16] recommended a high-frequency (12-17 MHz) linear transducer for superficial masses because of its high spatial resolution. ...
... 11,[17][18][19][20][21][22]. Mandava et al.[23] have reported that normal skin is consist of three layers: The epidermis (thickness 0.06-0.6 ...
... Tokyo, Japan). We have provided several studies in the dermatologic field [4][5][6][7][8][9][10][11]. ...
... We usually perform US tests for dermatologic diseases with a high-resolution, broad-band (5MHz-18MHz) linear transducer (Nobulus Hitachi, Ltd.Tokyo, Japan). Until now we have reported many studies in the dermatologic field [13,[17][18][19][20][21][22]. ...
... The minimum frequency recommended for performing dermatologic examinations was 15MHz [2,3]. We usually perform US examinations for dermatologic diseases with a high-resolution, broad-band (5MHz-18MHz) linear transducer (Nobulus Hitachi, Ltd.Tokyo, Japan) and have described some reports [4][5][6][7][8][9]. ...
... Tokyo, Japan). Until now, we have reported some studies in relation to the skin and subcutaneous disease [13][14][15][16][17]. Epidermal cyst is considered as level 1 content of the training program in dermatologic ultrasound by the international working group, called DERMUS [2]. ...
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