Yoshida Hiroshi, Kikkawa Nao, Takigawa Waku, Uno Masaya, Ishikawa Mitsuya
Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Department of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Ann Diagn Pathol. 2025 Apr;75:152426. doi: 10.1016/j.anndiagpath.2024.152426. Epub 2024 Nov 29.
Deep angiomyxoma (DA) is a rare, slow-growing soft tissue tumor typically affecting women of reproductive age. Despite its benign histology, it poses significant clinical challenges due to local invasiveness and high recurrence. Accurate diagnosis through radiologic imaging, particularly MRI, is essential for guiding treatment. One key imaging feature of DA is the "swirl sign," a distinctive pattern on T2-weighted images. However, its histological basis remains unclear. Here, we present a case of DA in a 46-year-old woman, highlighting the correlation between radiologic and histopathologic findings. MRI showed the characteristic swirl sign, which histologically corresponded to straight-running blood vessels aligned with the tumor's long axis, supported by collagen fibers within an edematous stroma. This case offers novel insight into the origins of the swirl sign and provides research questions on this sign. Further research is needed to explore its potential as a biomarker for tumor growth and aggressiveness.
深部血管黏液瘤（DA）是一种罕见的、生长缓慢的软组织肿瘤，通常影响育龄女性。尽管其组织学表现为良性，但由于局部侵袭性和高复发率，它带来了重大的临床挑战。通过放射影像学检查，尤其是磁共振成像（MRI）进行准确诊断对于指导治疗至关重要。DA的一个关键影像学特征是“漩涡征”，这是T2加权图像上的一种独特表现。然而，其组织学基础仍不清楚。在此，我们报告一例46岁女性的DA病例，突出了放射学和组织病理学发现之间的相关性。MRI显示了特征性的漩涡征，组织学上这与沿肿瘤长轴排列的直行血管相对应，周围有水肿基质内的胶原纤维支持。该病例为漩涡征的起源提供了新的见解，并提出了关于此征象的研究问题。需要进一步研究以探索其作为肿瘤生长和侵袭性生物标志物的潜力。
