PMC2698087_01
MR imaging of the right proximal leg. Axial T1-weighted (A) and T2-weighted (B) MR images depict a well-circumscribed, elliptical mass (arrows) with a central, fusiform, fluid-filled cavity in the deep subcutaneous layer of the right proximal leg. Note the wavy, low-signal-intensity structures (arrowhead) in the central cavity, representing the gauze fibers.
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F1
Because the mass was thought to be a soft-tissue tumor, MRI was performed; spin-echo T1-weighted (TR/TE: 419/17.8) and fast spin-echo T2-weighted (TR/TE: 1876/90) images revealed an elliptical, well-circumscribed mass in the anterolateral aspect of the right proximal leg, abutting the crural fascia (Figs. 1A, B).
Gross pathologic specimen shows a well-encapsulated mass with a fusiform central cavity. The gauze fibers (arrows) are clearly depicted.
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F2
At surgery, a well-encapsulated, brownish soft-tissue tumor containing serous fluid was discovered in the central cavity; examination of a cross-sectional specimen revealed the presence of fiber-like material, shown at histological investigation to be gauze fibers (Fig. 2).
Microscopic examination of the tumor revealed fibrosis, and lymphocyte and giant cell infiltration had occurred. Note the presence of giant cells, which phagocytosed the gauze fibers (arrow).
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F3
Microscopically, the tumor showed granulomatous inflammation, with fibrosis, lymphocyte infiltration, and giant cell reaction (Fig. 3).