Association of Magnetic Resonance Imaging Features with Angioleiomyoma Histologic Subtype

Abstract

Background: Angioleiomyomas are usually small and relatively rare painful soft tissue tumors, and are usually less than 2 cm in diameter. Magnetic resonance (MR) imaging features of typical angioleiomyomas are not well understood, and their association with histologic subtypes is not clear. In the present study, MR images of average sized angioleiomyomas were compared with regard to specific histologic subtypes. Methods: We performed a retrospective review of medical records, MR imaging data, and histologic specimens of 18 consecutive patients with angioleiomyomas that were extirpated at our hospital between January 2006 and December 2013. Results: Most of the lesions showed homogenous iso-signal intensities compared to skeletal muscle on T1-weighted images; however, on T2-weighted images, solid and venous types showed heterogenous and iso-to slightly high-signal intensity, while the cavernous type showed high-signal intensity. Most of the lesions had a low-signal intensity rim, and two thirds of them had adjacent vessels. Conclusions: Our results suggested that MR findings of angioleiomyoma vary depending on histologic subtypes. T2-weighted images of solid and venous types of angioleiomyoma show specific MR findings which allow for differentiation from other soft tissue tumors such as soft tissue sarcomas. These mostly show iso-to slightly high-signal intensity compared to skeletal muscle, while the cavernous type show non-specific findings. Thus, solid and venous types of angioleiomyoma could be diagnosed preoperatively via clinical findings and MR imaging.

Mediastinal cavernous angioleiomyoma: A case report and review of literature

“…Initially, ALM was considered a smooth muscle tumor. However, it was reclassified in the World Health Organization (WHO) classification of tumors as a pericyte (perivascular) tumor (4). ALM tends to occur in individuals aged 40-60 years and primarily in females (female/male ratio: 1.7:1) (5).…”