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Figure 4a. Painful intramuscular nodular fasciitis in the upper arm of a 46-year-old woman. (a) Axial T2-weighted image shows a 3 x 3.5-cm hyperintense mass in the medial triceps. The mass has lower signal intensity along its periphery (arrow). (b) Coronal gadolinium-enhanced T1-weighted image shows peripheral enhancement of the lesion, with no appreciable enhancement in the predominantly myxoid center. (c) The nodule was exposed and removed with marginal excision after surgical dissection through the long head of the triceps. (d) Photomicrograph (H-E stain) shows fascia (lower left) with typical myxoid degeneration (M) predominantly in the central portion of the lesion. Note the peripheral parallel vessels at the interface between the fascia and the lesion.
