PMC9537629_01
Magnetic resonance imaging (MRI) showed abnormal soft tissue nodules around the iliac vessels in the left groin, T1WI sequence was isointense with muscle tissue (A,a) white arrow levels the plane of the greater trochanter, black arrow levels the plane of the femoral head), and T2WI was slightly hyperintense (B,b). Diffusion-weighted imaging showed obvious high signal (C,c), and contrast-enhanced scan showed obvious homogeneous enhancement (D).
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F1
Magnetic resonance imaging (MRI) was recommended for the nature of these soft tissue masses, which showed isointensity with muscle tissue on T1WI and T2WI (as shown in Figure 1).
Fluoro18-labeled deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of the patient, the maximum intensity projection [MIP, (A)] showed multiple mild to moderate radioactive uptake foci in the left inguinal region (white arrow levels the plane of the greater trochanter, black arrow levels the plane of the femoral head). The axial figures in the left inguinal region at the femoral head level [(B) CT; (C) PET; (D) PET/CT fusion] and greater trochanter level [(E) CT; (F) PET; (G) PET/CT fusion] showed soft tissue nodules with radioactive uptake, with SUVmax of 5.3 (black arrow) and 4.5 (white arrow), respectively.
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F2
To further systematically evaluate the patient's whole-body condition, the patient underwent 18F-FDG PET/CT examination (as shown in Figure 2), of which results showed that there were multiple nodules with increased radioactivity uptake of different sizes in the left inguinal region, with maximum standard uptake value (SUVmax) ranging from 4.5 to 5.3, and no obvious abnormal radioactive uptake foci were found in the rest of the body.
Hematoxylin-eosin staining showed lymphocyte proliferation in the lesions with diffuse eosinophil infiltration [(A) 100 x magnification; (B) 400 x magnification arrows indicate eosinophilic microabscesses].
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F3
Postoperative pathological and immunohistochemical examination (as shown in Figure 3) of the excised mass showed that it was an eosinophilic lymphogranuloma, that is, Kimura's disease (KD), and the gene test result was wild type.