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Nodular Fasciitis: Sonographic-Pathologic Correlation.

Ho-Hsian Yen1, Hong-Jen Chiou1, Yi-Hong Chou1

  • 1Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.

Ultrasound in Medicine & Biology
|January 10, 2017
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Summary

This study correlates sonographic and histopathologic features of nodular fasciitis (NF). Infiltrating NF patterns often show inhomogeneous hypo-echoic lesions with echogenic rims and peripheral nodules on ultrasound.

Keywords:
Echogenic rimHistopathologyNodular fasciitisUltrasound

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Area of Science:

  • Radiology
  • Pathology
  • Oncology

Background:

  • Nodular fasciitis (NF) is a benign soft tissue proliferation.
  • Accurate diagnosis of NF is crucial for appropriate patient management.
  • Understanding the imaging characteristics of NF can aid in differentiating it from malignant neoplasms.

Purpose of the Study:

  • To evaluate nodular fasciitis (NF) in 19 patients.
  • To correlate sonographic features with histopathologic findings in NF.
  • To identify specific ultrasound characteristics associated with different NF patterns.

Main Methods:

  • Retrospective review of sonograms from 19 patients with histopathologically confirmed NF.
  • Analysis of sonographic features including location, shape, margin, echogenicity, echogenic rim, peripheral hyper-echoic nodules, posterior enhancement, and vascularity.
  • Histopathologic classification of NF patterns (infiltrating, pushing border, well circumscribed) and collagen bundle distribution.

Main Results:

  • Most NF cases exhibited inhomogeneous hypo-echoic lesions with an echogenic rim and an infiltrating or pushing border pattern on sonography.
  • All NF cases with an infiltrating pattern showed peripheral hyper-echoic nodules in their sonograms.
  • Echogenic rims may correlate with peripheral adipose tissues in infiltrating NF patterns.

Conclusions:

  • Sonographic features like echogenic rims and peripheral hyper-echoic nodules are associated with specific histopathologic patterns of nodular fasciitis.
  • The degree of infiltration in NF may correlate with distinct sonographic findings.
  • Ultrasound can be a valuable tool in the diagnostic workup of nodular fasciitis, complementing histopathologic analysis.