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Angioleiomyoma of the extremities: correlation of magnetic resonance imaging with histopathological findings in 25 cases

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Abstract

Objective

To identify the characteristic magnetic resonance imaging (MRI) findings in angioleiomyoma and to clarify its relationship with histopathological findings.

Materials and methods

We retrospectively analyzed the MRI findings and pathological subtypes in 25 patients with subcutaneous angioleiomyoma of the extremities. Based on the previous reports, MRI findings that could be characteristic of angioleiomyoma were extracted. According to the World Health Organization classification, all cases were classified into three pathological subtypes: solid, venous, and cavernous. The relationship between MRI findings and pathological subtypes was analyzed.

Results

The pathological subtypes were solid (n = 10), venous (n = 11), and cavernous (n = 4). The following MRI findings were observed: (a) hypo- or iso-intense linear and/or branching structures on a T2-weighted image (positive total/solid/venous/cavernous: 19/5/10/4, respectively), which we defined as “dark reticular sign”; (b) peripheral hypointense rim on a T2-weighted image (positive total/solid/venous/cavernous: 19/7/8/4, respectively); and (c) presence of any adjacent vascular structures (positive total/solid/venous/cavernous: 6/3/3/0, respectively). Chi-square test showed a significant relationship between dark reticular sign and pathological subtypes (p = 0.0426). The dark reticular sign was found more frequently in the venous and cavernous types than in the solid type. The other MRI findings did not reveal a significant relationship between pathological subtypes.

Conclusion

We present the largest case series exploring MRI findings in angioleiomyoma. The dark reticular sign was a characteristic MRI finding of angioleiomyoma and was seen in most of the venous and cavernous types, which may facilitate preoperative diagnosis.

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Acknowledgements

We would like to thank Editage (http://www.editage.com) for editing this manuscript for English language.

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Authors and Affiliations

  1. Department of Radiology, National Defense Medical College, Saitama, Japan

    Hiromi Edo, Ayako Mikoshi & Hiroshi Shinmoto

  2. Department of Pathology and Laboratory Medicine, National Defense Medical College, Saitama, Japan

    Ayano Matsunaga & Susumu Matsukuma

  3. Department of Orthopedic Surgery, National Defense Medical College, Saitama, Japan

    Michiro Susa & Keisuke Horiuchi

Authors
  1. Hiromi Edo
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  2. Ayano Matsunaga
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  3. Susumu Matsukuma
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  4. Ayako Mikoshi
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  5. Michiro Susa
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  6. Keisuke Horiuchi
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  7. Hiroshi Shinmoto
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Contributions

Hiromi Edo and Hiroshi Shinmoto were involved in study design, acquisition of data, analysis and interpretation of data, and drafting the manuscript. Ayano Matsunaga and Susumu Matsukuma were involved in acquisition of data, analysis and interpretation of data, and drafting the manuscript. Ayako Mikoshi was involved in analysis and interpretation of data and drafting the manuscript. Michiro Susa and Keisuke Horiuchi were involved in data collection and drafting the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hiromi Edo.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the institutional ethics committee (4302).

Informed consent

Approval from the Institutional Review Board was obtained, and in keeping with the policies for a retrospective review, informed consent was not required. In addition, the patient’s records were anonymously analyzed.

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Edo, H., Matsunaga, A., Matsukuma, S. et al. Angioleiomyoma of the extremities: correlation of magnetic resonance imaging with histopathological findings in 25 cases. Skeletal Radiol 51, 837–848 (2022). https://doi.org/10.1007/s00256-021-03888-4

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  • DOI: https://doi.org/10.1007/s00256-021-03888-4

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