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Pilomatricomas in children: imaging characteristics with pathologic correlation
Hyun Wook Lim1, Soo Ah Im, Gye-Yeon Lim
1Department of Radiology, Kangnam St. Mary's Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-701, South Korea.
Insights
Pilomatricoma imaging in children is often poorly understood. This study details US, CT, and MR findings, correlating them with pathology to improve diagnosis of this common pediatric skin nodule.
Area of Science:
- Radiology
- Pediatric Imaging
- Dermatopathology
Background:
- Pilomatricoma is a common pediatric skin tumor with poorly defined imaging characteristics.
- Lack of consensus exists regarding imaging findings and histopathologic correlations.
Purpose of the Study:
- To characterize radiologic appearances of pilomatricomas using ultrasound (US), CT, and MRI.
- To correlate imaging findings with histopathologic features.
Main Methods:
- Retrospective analysis of 47 pilomatricoma cases.
- Evaluation of imaging findings on US (n=17), CT (n=31), and MRI (n=5).
- Comparison of imaging data with reviewed histopathologic specimens.
Main Results:
- Lesions appeared as well-circumscribed, subcutaneous nodules attached to skin.
- US showed hyperechoic nodules with shadowing and hypoechoic rim.
- CT revealed enhancing soft-tissue masses with calcifications; MRI showed internal reticulations and patchy areas.
Conclusions:
- Pilomatricoma diagnosis should consider well-defined hyperechoic or calcific subcutaneous nodules on US or CT in children.
- MRI can aid in diagnosis.
- Imaging findings correlate well with histopathologic features.
Background:
Although pilomatricoma commonly occurs in children, there is still a poor understanding of the imaging characteristics of pilomatricoma and lack of agreement regarding its imaging findings and histopathologic features.
Objectives:
To characterize the radiologic appearance of pilomatricomas on US, CT, and MR and to correlate the imaging findings with histopathologic features.
Materials And Methods:
The imaging findings of 47 pilomatricomas on US (n = 17), CT (n = 31), and MR (n = 5) were retrospectively evaluated. Pathologic specimens of all cases were reviewed and compared with imaging findings.
Results:
All lesions were well-circumscribed, subcutaneous nodules with partial attachment to the overlying skin. On US, the lesions were mostly hyperechoic with posterior acoustic shadowing and hypoechoic rim. On CT, they appeared as enhancing soft-tissue masses with varying amounts of calcification. MR findings were internal reticulations and patchy areas on T2-weighted images and contrast-enhanced T1-weighted images, corresponding to edematous stroma on pathology. Peritumoral inflammatory changes and connective capsule on pathology were well correlated with imaging findings.
Conclusion:
Pilomatricoma should be considered when US or CT shows a well-defined hyperechoic or calcific nodule in subcutaneous fat attached to the skin in children. MR images may be helpful in diagnosis. Pathologic findings are well correlated with imaging findings.
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