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表现为疼痛性皮下肿块的血管平滑肌瘤:一项诊断挑战。

Angiomyoma presenting as a painful subcutaneous mass: a diagnostic challenge.

作者信息

Kumar Sandeep, Hasan Roumina, Maddukuri Satish Babu, Mathew Mary

机构信息

Department of Radiodiagnosis, Kasturba Medical College, Manipal, Karnataka, India.

Department of Pathology, Melaka Manipal Medical College, Manipal, Karnataka, India.

出版信息

BMJ Case Rep. 2014 Oct 16;2014:bcr2014206606. doi: 10.1136/bcr-2014-206606.

Abstract

Angiomyoma of the extremity is a notoriously elusive preoperative diagnosis, as the list of differentials for its described classic clinical features of a painful mobile subcutaneous mass is quite vast. Imaging features described for angiomyomas are far from being specific. On ultrasound, angiomyomas are mostly described as a well-defined solid mass lesion showing robust internal vascularity. On T2-weighted MRI they have been described as homogenous to heterogeneously hyperintense relative to skeletal muscle. We report a pathologically proven angiomyoma around the knee joint in a middle aged man, describe its clinical and imaging features, and outlay an approach in diagnosing this rare entity as a differential for painful subcutaneous mass lesions.

摘要

肢体血管平滑肌瘤术前诊断极难明确,因为其典型临床特征为疼痛性可移动皮下肿块,鉴别诊断范围很广。血管平滑肌瘤的影像学特征远不具有特异性。在超声检查中,血管平滑肌瘤大多被描述为边界清晰的实性肿块病变,内部血管丰富。在T2加权磁共振成像上,相对于骨骼肌,它们被描述为从均匀到不均匀的高信号。我们报告一例经病理证实的中年男性膝关节周围血管平滑肌瘤,描述其临床和影像学特征,并阐述将这种罕见实体作为疼痛性皮下肿块病变鉴别诊断的诊断方法。

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