PMC4349102_01
Axial ultrasonographic image showing hypoechoic cable-like neural fascicle (arrows) separated by substratum hyperechoic fat
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Sonography of the swelling demonstrated enlarged cross-section of the median nerve (4.3 cm2; normal cross-section, 5.78 +- 0.9 mm2) under the flexor retinaculum with hypoechoic cable-like neural fascicle separated by hyperechoic fat (Figure 1).
Axial ultrasonographic image showing involvement of upper portion of median nerve (arrows)
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On ultrasonographic evaluation, the median nerve involvement was extended to the proximal forearm at the level of pronator teres muscle (Figure 2).
Magnetic resonance image showing typical "coaxial cable-like" appearance of median nerve in T2-TSE sequence
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On axial image, the lesion demonstrated a characteristic "coaxial cable-like" appearance (Figure 3).
The intraoperative view of the enlarged median nerve of the patient at distal forearm and carpal tunnel region
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At surgery, enlargement of the median nerve under the flexor retinaculum in the distal forearm and carpal tunnel was observed (Figure 4).
The histopathologic view shows infiltration of the perineurium of the median nerve by mature fibrous and adipose Tissue (Hematoxylin and Eosin staining; magnification, x 100)
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Histopathologic study demonstrated infiltration of perineurium with mature fibrous and adipose tissue (Figure 5).