Won Kyu Yeoun, Park So Young, Jin Wook, Lew Bark-Lynn
1 Department of Pathology, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
2 Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
Acta Radiol. 2018 Apr;59(4):454-459. doi: 10.1177/0284185117721263. Epub 2017 Aug 9.
Background Ultrasound has been increasingly used for the evaluation of superficial soft tissue lesions. Dermatofibroma is one of the most common dermal lesions. Experiences in ultrasound examinations of dermatofibromas have been accumulated. Purpose To evaluate sonographic findings of dermatofibroma and to correlate them with pathologic findings. Material and Methods A total of 18 dermatofibromas in 15 patients were included. Sonographic findings were assessed for location, depth, size, shape, margin, spiculation, echogenicity, internal hyperechoic dots, change in echogenicity of adjacent soft tissue, and vascularity, by two musculoskeletal radiologists in consensus. Pathologic findings were evaluated by one pathologist. Ultrasonographic characteristics were correlated with the pathologic findings by discussion between one radiologist and one pathologist. Results On ultrasound, all lesions were found to be located in the dermis, and 14 lesions (78%) extended into the subcutaneous layer. Mean size was 7 mm (range = 3 to 10 mm). Characteristic findings were ill-defined margins (n = 15, 83%), spiculated margins (n = 12, 67%), change in echogenicity of adjacent soft tissue (n = 14, 78%), and no Doppler flow (n = 14, 78%). Histologically, depth, margin, and spiculation were correlated with sonographic findings. Reactive fibrosis and chronic inflammation were seen in adjacent dermis and subcutaneous fat layer of echogenicity change. Conclusion On ultrasound, dermatofibromas are usually visible as avascular dermal lesions with extension into the subcutaneous layer, and are characterized by ill-defined margins, marginal spiculation, and change in echogenicity of surrounding soft tissues.
超声已越来越多地用于评估浅表软组织病变。皮肤纤维瘤是最常见的皮肤病变之一。在皮肤纤维瘤的超声检查方面已积累了经验。目的：评估皮肤纤维瘤的超声表现，并将其与病理结果相关联。材料与方法：纳入15例患者的18个皮肤纤维瘤。由两名肌肉骨骼放射科医生共同评估超声表现，包括位置、深度、大小、形状、边缘、毛刺征、回声性、内部高回声点、相邻软组织回声性改变以及血管情况。由一名病理科医生评估病理结果。通过一名放射科医生和一名病理科医生之间的讨论，将超声特征与病理结果相关联。结果：超声检查发现，所有病变均位于真皮层，14个病变（78%）延伸至皮下层。平均大小为7毫米（范围为3至10毫米）。特征性表现为边界不清（n = 15，83%）、边缘有毛刺征（n = 12，67%）、相邻软组织回声性改变（n = 14，78%）以及无多普勒血流信号（n = 14，78%）。组织学上，深度、边缘和毛刺征与超声表现相关。在回声性改变的相邻真皮层和皮下脂肪层可见反应性纤维化和慢性炎症。结论：超声检查时，皮肤纤维瘤通常表现为无血管的真皮层病变并延伸至皮下层，其特征为边界不清、边缘有毛刺征以及周围软组织回声性改变。
