Soft-Tissue Masses

In a cohort of 29 patients with suspected recurrent colorectal carcinoma referred for restaging Strunk et al. [31] retrospectively compared [ F]-FDG-PET alone, CT alone, [ F]-FDG-PET and CT virtually fused with simultaneously coregistered [ F]-FDG-PET/CT scans. Detection of lesions was most sensitive with coregistered [ F]-FDG-PET/CT scans. Discrepancies were mainly found in the lung and lymph nodes, where [ F]-FDG-PET alone detected often lymph nodes and soft tissue masses where CT alone was often negative. Coregistered [ F]-FDG-PET/CT scans provided additional information in 7 of... 

Hematopoietic neoplasms only rarely present as soft tissue masses, and this phenomenon is particularly unusual in pediatric patients in whom other forms of small round cell tumors are most common. Because of the virtually ubiquitous presence of CD45 in hematopoietic cells and its extremely high degree of specificity, that marker is very valuable in this context. Not all antibodies raised against CD45 identify determinants that survive routine tissue processing, but the monoclonal antibody cocktail PD7/26 2B11 (see Table 4.3) is indeed active in paraffin sections. 

Moran CA, Suster S, Perino G, et al. Malignant smooth muscle tumors presenting as mediastinal soft tissue masses A clinico-pathologic study of 10 cases. Cancer. 1994 74 2251-2260. 

Many plain radiographic signs of intussusception have been described. The most common is a soft-tissue mass, which is most often seen in the... 

Fig. 1.45. Meniscus sign. Plain radiograph shows the meniscus sign a rounded soft-tissue mass (the intussusceptum) protruding into the gas-filled transverse colon (arrow) [From del Pozo (1999)]...

Fig. 1.44a,b. Target sign. a,b Two different patients. Plain radiographs show a round soft-tissue mass in the right upper quadrant (arrows). The masses contain a ring-like area of lucency [From DEL Pozo (1999)]... 

Fig. 2.14a-d. Esophageal duplication cyst, a AP chest radiograph without appreciable abnormality, b Lateral chest radiograph with anterior bowing and narrowing of the airway above the carina. c Barium esophagram confirms the presence of a soft tissue mass, d Contrast-enhanced CT shows the cyst posterior to the airway, and deforming the airway arrow)... 

Plain abdominal X-ray may demonstrate a soft tissue mass in between the greater curvature of the stomach and superior to the transverse colon (Bareev and Weinberg 2004). This is seldom seen. 

Abdominal CT images may show diffuse small intestinal wall thickening and dilatation, mesenteric edema, ascites and possibly relatively low density confluent mesenteric soft tissue masses that represent lymphangiomas (Parker 2003). 

Fig. 6.6. AXR of a patient with intussusception. Note the soft tissue mass of the intussusception in the right iliac fossa and the dilated small bowel loops of obstruction...

Fig. 6.8a,b. Appearance of intussusception during reduction by air enema, a The soft tissue mass of the intussusception can be seen in the right flank and the remainder of the large bowel is distended by air. Air has not yet flooded back into the small bowel, which would indicate successful reduction, b Air enema in a different patient the intussusception is shown as a soft tissue mass but perforation of the bowel has occurred... 

Peritoneal parietal and serosal implants are visible on ultrasound as soft tissue masses or nodules adhering to the peritoneum, as irregularity or interruption of the anterior hyperechoic peritoneal line (Fig. 18.7). Visualisation is facilitated by the presence of ascites. The ultrasonographic study of the peritoneal line is facilitated by the use of high frequency ultrasound probes, which allow also visualization of very small peritoneal implants (Fig. 18.8 Lorenz et al. 1990). Peritoneal implants, serosal implants, and interruption of the anterior hyperechoic peritoneal line are present at the rates of about 54,19, and 16%, respectively in patients with peritoneal carcinomatosis (Rioux and Michaud 1995). 

TBW method). Although body impedance reflects tissue hydration, soft-tissue mass (lean and fat) can also be empirically derived by correlation in healthy subjects because the compartments of soft tissue are correlated with each other through physiological constants. However, physiological constants become flawed in patients with fluid disorders, which accounts for some of the conflicting results in the literature (Kyle et al., 2004). 

Karimi M, Koranyi J, Franco C, Peker Y, Eder DN, Angelhed JE, Lonn L, Grote L, Bengtsson BA, Svensson J, Hedner J, Johannsson G. Increased neck soft tissue mass and worsening of obstructive sleep apnea after growth hormone treatment in men with abdominal obesity. J Clin Sleep Med 2010 6(3) 256-63. 

An increasing number of examinations are being performed for the evaluation of known or suspected musculoskeletal infection. Multislice CT with 2D and 3D reconstructions are useful tools for detecting infections and abscesses, determining which compartments are involved and for describing the extent of an infection. For this question it is necessary to apply intravenous contrast medium. Multislice CT is also used to evaluate cortical bone and associated soft-tissue masses in suspected osteomyelitis. The presence of sequester can be verified and the response to therapy monitored (Knollmann and COAKLEY 2006). 

Heymsfield, S.B., Wang, J., Heshka, S., Kehayias, J.J., and Pierson, R.N. (1989) Dnal-Photon Absorptiometry Comparison of Bone Mineral and Soft Tissue Mass Measurements In Vivo with Established Methods, Am. J. Clin. Nutr. 49,1283-1289. 

Complex or thickened folds are typically encountered at the splenic and hepatic flexures. Axial CT images might raise the possibility of intraluminal soft tissue masses or tumoral thickened folds. Endo-luminal views are frequently helpful in identifying... 

Fig. 11.2a,b. Inflammation. Coronal MPR. Secondary cholesteatoma of the middle ear (a) with completely opacified tympanic cavity, destructed ossicles, small erosions along the walls of the tympanic cavity, and at the canal tympanic facial nerve segment (arrow), protrusion of the drum, soft tissue masses in the external auditory canal, reduced mastoid pnemiiatisation. 

Fig. 12.4a-f. Orbital metastasis of prostate cancer affects major wing of sphenoid bone and extraconal compartment of orbit, with bony spiculae extending into the intra-oibital soft tissue mass (arrows). Metastasis causes proptosis of left eyeball (axial MDCT images, a and b), compression of optic nerve in... 

Recurrent tumors after surgery are seen as a soft tissue mass in the region of the vaginal vault, usually with involvement of the adjacent parametrium. After radiotherapy, the tumor is seen as a mass within the cervix. The involvement of the pelvic floor or the sidewalls is essential for planning resection of primary and recurrent tumors. 

The Natowicz syndrome was described in a 14 year-old female with short stature, mildly dysmorphic features, flattened nasal bridge, bifid uvula, soft tissue cleft palate, and multiple periarticular soft-tissue masses in ankle, finger and patella. These masses were associated with pain and swelling. The basic enzyme defect in the Natowicz syndrome is a deficiency of hyaluronidase. Only one case of this disorder has been reported [6]. 

Fig. 2.1. Sixteen-year-old male. Lateral X-ray of the left wrist shows a ventral soft tissue mass associated with typical phle-bolith in a case of venous malformation...

Fig.2.2a-c. Six-year-old boy with a stable soft tissue mass of the right temporal region, a US shows an heterogeneous hypoechoic well-delimited superficial lesion containing anechoic structures, b The same lesion is compressible and seems not vascularized, c Low velocity flow is detected when the compression is released (venous malformation)... 

Siegel MJ (2001) Magnetic resonance of musculoskeletal soft tissue masses. Radiol Clin North Am 39 701-720... 

Ectopic ureterocele develops at the lower end of the upper pole ureter of a duplicated kidney. It is a cyst-like thin-walled structure that is known to be mobile and variable in shape. During fetal life, the ureterocele can prolapse into the posterior urethra and create obstruction (Fig. 6.9). Bilateral hydronephrosis and megacystis can subsequently develop. Clinical diagnosis can be made at birth in girls with a perineal soft tissue mass, megacystis and bilateral urinary tract obstruction. Sonographic diagnosis can be difficult when the ectopic ureterocele has... 

Soft tissue masses of the subcutaneous tissue include a variety of lesions, such as calcifications, tophaceous gout or rheumatoid nodules, sebaceous cysts... 

Superficial lipomas typically appear as compressible, palpable soft-tissue masses in the subcutaneous tissue not adherent with the overlying skin. Lipomas have a male and familial predominance and tend to grow in the hack, shoulder and upper arms with a predilection for the extensor surface. They are more common in the fifth and sixth decades. Although lipomas most often present as a solitary... 

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