PMC4959455_01
A well-demarcated ovoid-shaped mass with mixed echogenicity in the left inguinal area on ultrasound (A). Power Doppler imaging revealed minimal vascularity within the mass (B).
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In the sonographic examination, a well-demarcated hypoechoic ovoid-shaped mass (46x28 mm) in the left inguinal area of probable nodal origin was detected (Figure 1A). Power Doppler imaging revealed minimal vascularity within the mass with a relatively high resistive index of 0.82 (Figure 1B).
B-mode sonographic image showing a hypoechoic mass with a regular shape (left). Sonoelastographic image showing a predominantly blue lesion (blue color denotes the hardness) (A). Elastographic exam [Q-Analysis by GE Healthcare machine, E-Index (Elasticy Index)] revealed features of hard tissue characteristics with a 4.6 score (measurement range: 0-6; high scores denote the hardness) (B). The mass has a hardness of 8.8 fold compared with subcutaneous fat tissue on elastographic measurement (E-Ratio) (C).
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The elastographic exam revealed characteristics of hard tissue with a 4.6 score coded in blue (measurement range: 0-6; high scores and blue color denote the hardness) (Figure 2A-2C).
Spindle tumor cells showing a vaguely palisaded pattern in the collagenous matrix (cytologic feature) (A). Spindle cells showing a palisading arrangement in the collagenous background (cellblock histology) (B).
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The initial cytological examination was suggestive of schwannoma but cellblock histomorphology and consequent immunohistochemical studies revealed that the diagnosis was consistent with intranodal palisaded myofibroblastoma (Figure 3A, 3B).