PMC4220419_01
27-year-old right-hand dominant female patient with a swelling on the proximal phalanx of her right 3rd finger diagnosed as Ewing's sarcoma. X-ray of the right hand AP view shows swelling of the soft tissue and increase in the density of the proximal phalanx of the 3rd finger (arrow).
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F1
Conventional radiographs revealed preserved bone contours, surrounding soft tissue swelling, and increase in the opacity of the proximal phalanx of the 3rd finger [Figure 1].
27-year-old right-hand dominant female patient with a swelling on the proximal phalanx of her right 3rd finger diagnosed as Ewing's sarcoma. (a) T1W coronal, (b) T2W sagittal, (c) T1W axial contrast enhanced images of the right hand 3rd finger, proximal phalanx palmar side, neighboring the flexor tendon, show a lesion hypointense on T1W (arrow), hyperintense on T2W (arrow), with contrast enhancement (solid arrow).
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F2
T2-weigthed (T2W) images [Figure 2a-c]. The neighboring bone cortex was natural in appearance and no metastasis was detected in the preoperative computed tomography (CT) of the thorax and in the full-body scintigraphy. The lesion was surgically excised and a microscopic evaluation showed tumor cells that were round in shape with vesicular nuclei, finely dispersed chromatin, narrow cytoplasm, and stratified monotonous cells with indistinct borders.
27-year-old right-hand dominant female patient with a swelling on the proximal phalanx of her right 3rd finger diagnosed as Ewing's sarcoma. Excised tissue stained with hematoxylin and eosin (x400) shows Ewing's sarcoma tumor cells in parts with clear appearance due to presence of glycogen (arrow).
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F3
In places, the cytoplasm could be clearly seen due to the glycogen content [Figure 3].