HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Murphey, M. D. Articles by Temple, H. T. Search for Related Content PubMed PubMed Citation Articles by Murphey, M. D. Articles by Temple, H. T. Related Collections Musculoskeletal Radiology

From the Archives of the AFIP ¹

Imaging of Musculoskeletal Neurogenic Tumors: Radiologic-Pathologic Correlation

¹ From the Department of Radiologic Pathology, Armed Forces Institute of Pathology, 6825 16th Street NW, Bldg 54, Room M-133A, Washington, DC 20306 (M.D.M., W.S.S., S.E.S.); Departments of Radiology and Nuclear Medicine (M.D.M., W.S.S.) and Surgery (H.T.T.), Uniformed Services University of the Health Sciences, Bethesda, Md; Department of Radiology, University of Maryland School of Medicine, Baltimore (M.D.M., S.E.S.); Department of Surgery, Orthopedic Service, Walter Reed Army Medical Center, Washington, DC (H.T.T.); Department of Radiology, St Mary's Hospital, Richmond, Va (M.J.K.). Received April 8, 1999; revision requested April 26 and received May 28; accepted June 1. Presented as a scientific exhibit at the 1995 RSNA scientific assembly. Address reprint requests to M.D.M.

Numerous neurogenic tumors can affect the musculoskeletal system, including traumatic neuroma, Morton neuroma, neural fibrolipoma, nerve sheath ganglion, neurilemoma, neurofibroma, and malignant peripheral nerve sheath tumors (PNSTs). The diagnosis of neurogenic tumors can be suggested from their imaging appearances, including lesion shape and intrinsic imaging characteristics. It is also important to establish lesion location along a typical nerve distribution (eg, plantar digital nerve in Morton neuroma, median nerve in neural fibrolipoma, large nerve trunk in benign and malignant PNSTs). Traumatic and Morton neuromas are commonly related to an amputation stump or are located in the intermetatarsal space, respectively. Neural fibrolipomas show fat interspersed between nerve fascicles and are often associated with macrodactyly. Nerve sheath ganglion has a cystic appearance and commonly occurs about the knee. Radiologic characteristics of neurilemoma, neurofibroma, and malignant PNST at computed tomography (CT), ultrasonography, and magnetic resonance imaging include fusiform shape, identification of entering and exiting nerve, low attenuation at CT, target sign, fascicular sign, split-fat sign, and associated muscle atrophy. Although differentiation of neurilemoma from neurofibroma and of benign from malignant PNST is problematic, recognition of the radiologic appearances of neurogenic tumors often allows prospective diagnosis and improves clinical management of patients.

Index Terms: Nervous system, neoplasms, 4.315, 4.325, 4.364 • Neurofibromatosis, 4.1444, 4.1831 • Neuroma, 4.315, 4.364

This article has been cited by other articles:

				W.-C. Tsai, H.-J. Chiou, Y.-H. Chou, H.-K. Wang, S.-Y. Chiou, and C.-Y. Chang Differentiation Between Schwannomas and Neurofibromas in the Extremities and Superficial Body: The Role of High-Resolution and Color Doppler Ultrasonography J. Ultrasound Med., February 1, 2008; 27(2): 161 - 166. [Abstract] [Full Text] [PDF]

				M. L. C. Fogata and K. A. Jain Sacral Nerve Sheath Tumor Simulates a Pedunculated Fibroid on Sonography J. Ultrasound Med., October 1, 2007; 26(10): 1457 - 1459. [Full Text] [PDF]

				Answers Practical Neurology, June 1, 2007; 7(3): 204 - 205. [Full Text] [PDF]

				R. J. Hughes, K. Ali, H. Jones, S. Kendall, and D. A. Connell Treatment of Morton's Neuroma with Alcohol Injection Under Sonographic Guidance: Follow-Up of 101 Cases Am. J. Roentgenol., June 1, 2007; 188(6): 1535 - 1539. [Abstract] [Full Text] [PDF]

				W. Chen, J.-W. Jia, and J.-R. Wang Soft Tissue Diffuse Neurofibromas: Sonographic Findings J. Ultrasound Med., April 1, 2007; 26(4): 513 - 518. [Abstract] [Full Text] [PDF]

				O H Woo, H S Yong, J B Lee, A Kim, B H Koo, and E-Y Kang A giant malignant peripheral nerve sheath tumour of the breast: CT and pathological findings Br. J. Radiol., February 1, 2007; 80(950): e44 - e47. [Abstract] [Full Text] [PDF]

				J TEH and G Whiteley MRI of soft tissue masses of the hand and wrist Br. J. Radiol., January 1, 2007; 80(949): 47 - 63. [Full Text] [PDF]

				G. Andreisek, D. W. Crook, D. Burg, B. Marincek, and D. Weishaupt Peripheral Neuropathies of the Median, Radial, and Ulnar Nerves: MR Imaging Features RadioGraphics, September 1, 2006; 26(5): 1267 - 1287. [Abstract] [Full Text] [PDF]

				G. Girish, D. A. Jamadar, D. Landry, K. Finlay, J. A. Jacobson, and L. Friedman Sonography of intramuscular myxomas: the bright rim and bright cap signs. J. Ultrasound Med., July 1, 2006; 25(7): 865 - 869. [Abstract] [Full Text] [PDF]

				S. H. Hong, H. W. Chung, J.-Y. Choi, Y. H. Koh, J.-A. Choi, and H. S. Kang MRI findings of subcutaneous epidermal cysts: emphasis on the presence of rupture. Am. J. Roentgenol., April 1, 2006; 186(4): 961 - 966. [Abstract] [Full Text] [PDF]

				K. Shimizu, H. Iwai, K. Ikeda, N. Sakaida, and S. Sawada Intraparotid Facial Nerve Schwannoma: A Report of Five Cases and an Analysis of MR Imaging Results AJNR Am. J. Neuroradiol., June 1, 2005; 26(6): 1328 - 1330. [Abstract] [Full Text] [PDF]

				K. P. Banks The Target Sign: Extremity Radiology, March 1, 2005; 234(3): 899 - 900. [Full Text] [PDF]

				A. D. Levy, N. Patel, N. Dow, R. M. Abbott, M. Miettinen, and L. H. Sobin From the Archives of the AFIP: Abdominal Neoplasms in Patients with Neurofibromatosis Type 1: Radiologic-Pathologic Correlation RadioGraphics, March 1, 2005; 25(2): 455 - 480. [Abstract] [Full Text] [PDF]

				L. M. Wilkinson, D. Manson, and C. R. Smith Best Cases from the AFIP: Plexiform Neurofibroma of the Bladder RadioGraphics, October 1, 2004; 24(suppl_1): S237 - S242. [Full Text] [PDF]

				W.-H. Jee, S.-N. Oh, T. McCauley, K.-N. Ryu, J.-S. Suh, J.-H. Lee, J.-M. Park, K.-A. Chun, M.-S. Sung, K. Kim, et al. Extraaxial Neurofibromas Versus Neurilemmomas: Discrimination with MRI Am. J. Roentgenol., September 1, 2004; 183(3): 629 - 633. [Abstract] [Full Text] [PDF]

				M. D. Murphey, J. F. Carroll, D. J. Flemming, T. L. Pope, F. H. Gannon, and M. J. Kransdorf From the Archives of the AFIP: Benign Musculoskeletal Lipomatous Lesions RadioGraphics, September 1, 2004; 24(5): 1433 - 1466. [Abstract] [Full Text] [PDF]

				A. Ogose, T. Hotta, T. Morita, T. Higuchi, H. Umezu, S. Imaizumi, H. Hatano, H. Kawashima, W. Gu, and N. Endo Diagnosis of Peripheral Nerve Sheath Tumors around the Pelvis Jpn. J. Clin. Oncol., July 1, 2004; 34(7): 405 - 413. [Abstract] [Full Text] [PDF]

				D. L. Reynolds Jr., J. A. Jacobson, P. Inampudi, D. A. Jamadar, F. S. Ebrahim, and C. W. Hayes Sonographic Characteristics of Peripheral Nerve Sheath Tumors Am. J. Roentgenol., March 1, 2004; 182(3): 741 - 744. [Abstract] [Full Text] [PDF]

				J. A. Lee and C. A. Boles Peripheral Schwannoma Lacking Enhancement on MRI Am. J. Roentgenol., February 1, 2004; 182(2): 534 - 535. [Full Text] [PDF]

				T Nakahara, H Fujii, J Hashimoto, H Yabe, H Morioka, and A Kubo Thallium-201 single-photon emission computed tomography in the detection of retroperitoneal schwannoma Br. J. Radiol., January 1, 2004; 77(913): 57 - 59. [Abstract] [Full Text] [PDF]

				R. M. Stuart, E. S. C. Koh, and W. H. Breidahl Sonography of Peripheral Nerve Pathology Am. J. Roentgenol., January 1, 2004; 182(1): 123 - 129. [Full Text] [PDF]

				H.-J. Chiou, Y.-H. Chou, S.-Y. Chiou, J.-B. Liu, and C.-Y. Chang Peripheral Nerve Lesions: Role of High-Resolution US RadioGraphics, November 1, 2003; 23(6): e15 - e15. [Abstract] [Full Text]

				P. A. Hrehorovich, H. R. Franke, S. Maximin, and P. Caracta Malignant Peripheral Nerve Sheath Tumor RadioGraphics, May 1, 2003; 23(3): 790 - 794. [Full Text] [PDF]

				M. D. Murphey, G. A. McRae, J. C. Fanburg-Smith, H. T. Temple, A. M. Levine, and A. J. Aboulafia Imaging of Soft-Tissue Myxoma with Emphasis on CT and MR and Comparison of Radiologic and Pathologic Findings Radiology, October 1, 2002; 225(1): 215 - 224. [Abstract] [Full Text] [PDF]

				H. Nishimura, Y. Zhang, K. Ohkuma, M. Uchida, N. Hayabuchi, and S. Sun MR Imaging of Soft-Tissue Masses of the Extraperitoneal Spaces RadioGraphics, September 1, 2001; 21(5): 1141 - 1154. [Abstract] [Full Text] [PDF]

				J. Lin and W. Martel Cross-Sectional Imaging of Peripheral Nerve Sheath Tumors: Characteristic Signs on CT, MR Imaging, and Sonography Am. J. Roentgenol., January 1, 2001; 176(1): 75 - 82. [Full Text]

				C. Martinoli, S. Bianchi, N. Gandolfo, M. Valle, S. Simonetti, and L. E. Derchi US of Nerve Entrapments in Osteofibrous Tunnels of the Upper and Lower Limbs RadioGraphics, October 1, 2000; 20(90001): 199S - 217. [Abstract] [Full Text]

				P. Henrot, J. Stines, F. Walter, N. Martinet, J. Paysant, and A. Blum Imaging of the Painful Lower Limb Stump RadioGraphics, October 1, 2000; 20(90001): 219S - 235. [Abstract] [Full Text]