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Pathologic and MR Imaging Features of Benign Fibrous Soft-Tissue Tumors in Adults¹

¹ From the Department of Diagnostic Radiology, Hospital of Saint Raphael, 1450 Chapel St, New Haven, CT 06511 (P.A.D.); Departments of Radiology (C.J.B., M.D.M.) and Pathology (J.T.M.), Walter Reed Army Medical Center, Washington, DC; Departments of Radiologic Pathology (M.D.M.) and Soft Tissue Pathology (J.C.F.), Armed Forces Institute of Pathology, Washington, DC; and Departments of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md (P.A.D., M.D.M.). Presented as an education exhibit at the 2005 RSNA Annual Meeting. Received April 17, 2006; revision requested May 1 and received June 7; accepted June 15. All authors have no financial relationships to disclose. Address correspondence to P.A.D. (e-mail: padinauer{at}yahoo.com).

Benign fibrous (fibroblastic or myofibroblastic) soft-tissue tumors are a heterogeneous group of fibrous lesions with widely varied anatomic locations, biologic behavior, and pathologic features. The four broad categories of fibrous proliferation are benign fibrous proliferations, fibromatoses, fibrosarcomas, and fibrous proliferations of infancy and childhood. The first two categories include nonaggressive fibroblastic lesions such as nodular fasciitis, as well as fibromatoses that demonstrate more aggressive biologic behavior (eg, desmoid tumors). In adults, fibrous tumors are among the most common soft-tissue lesions encountered in clinical practice. MR imaging can be useful for defining the intrinsic signal characteristics, size, and compartmental extension of these lesions. Histologic features of the tumor also may be depicted on T2-weighted MR images. Hypocellular fibrous tumors with dense collagenous components tend to have lower signal intensity on T2-weighted images than do lesions that are more cellular or that contain greater amounts of extracellular myxoid matrix. When interpreting MR images of soft-tissue masses in adults, radiologists should be aware of the clinical behavior, common sites of occurrence, and histopathologic and imaging features of the common benign fibrous soft-tissue tumors.

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