대한근골격영상의학회

Title : Case 144

Age / Sex : 53 / F Age / Sex : 53/female Chief complaint : a small palpable mass in little finger for 1 month. 1) What is your impression? Two weeks later, you can see the final diagnosis with a brief discussion of this case. * Send Application Answers to Ja-Young Choi, MD (drchoi01@gmail.com) Courtesy: Jee Young Kim, MD., St. Vincet’s Hospital, The Catholic University of Korea Diagnosis: Papillary endothelial hyperplasia(Masson’s angioma) Discussion Findings: (a) Sagittal T1WI shows a small ovoid hyposignal intense mass in volar side of subcutaneous fat layer. (b) Fat saturated coronal T2-weighted MR image shows an hypointense soft tissue mass with high signal intense wall. (c) Gadolinium enhanced fat saturated axial T1-weighted image shows thick wall enhancement with central nonenhanced portion in this mass. Diagnosis: Papillary endothelial hyperplasia(Masson’s angioma) Discussion: The pathogenesis of papillary endothelial hyperplasia is an unusual form of thrombus organization, with exuberant endothelial cell proliferation by an autocrine loop of endothelial base fibroblast growth fractor secretion. It is a predilection for the deep dermis and subcutis of the head, neck, fingers, and trunk, as small, firm, superficial nodules imparting a red to blue discoloration of the overlying skin. This is divided into three different types; primary or intravascular form, secondary or mixed form, and extravascular form. MR imaging features are hypointense or heterogeneous signal intensity with scattered high signal areas on T1WI, suggesting hemorrhage and low SI areas reflecting thrombotic or hemorrhagic material with low signal internal septae on T2WI and thick wall enhancement with nonenhanced center on contrast enhanced image.

Title : Case 144

Age / Sex : 53 / F

Age / Sex : 53/female

Chief complaint : a small palpable mass in little finger for 1 month.

1) What is your impression?

Two weeks later, you can see the final diagnosis with a brief discussion of this case.

* Send Application Answers to Ja-Young Choi, MD (drchoi01@gmail.com)

Courtesy: Jee Young Kim, MD., St. Vincet’s Hospital, The Catholic University of Korea

Diagnosis:

Papillary endothelial hyperplasia(Masson’s angioma)

Discussion

Findings: (a) Sagittal T1WI shows a small ovoid hyposignal intense mass in volar side of subcutaneous fat layer. (b) Fat saturated coronal T2-weighted MR image shows an hypointense soft tissue mass with high signal intense wall. (c) Gadolinium enhanced fat saturated axial T1-weighted image shows thick wall enhancement with central nonenhanced portion in this mass.

Diagnosis: Papillary endothelial hyperplasia(Masson’s angioma)

Discussion:

The pathogenesis of papillary endothelial hyperplasia is an unusual form of thrombus organization, with exuberant endothelial cell proliferation by an autocrine loop of endothelial base fibroblast growth fractor secretion. It is a predilection for the deep dermis and subcutis of the head, neck, fingers, and trunk, as small, firm, superficial nodules imparting a red to blue discoloration of the overlying skin.

This is divided into three different types; primary or intravascular form, secondary or mixed form, and extravascular form.

MR imaging features are hypointense or heterogeneous signal intensity with scattered high signal areas on T1WI, suggesting hemorrhage and low SI areas reflecting thrombotic or hemorrhagic material with low signal internal septae on T2WI and thick wall enhancement with nonenhanced center on contrast enhanced image.