Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Elastofibroma dorsi (bilateral)
- Radiologic Findings
- Initial chest PA (Fig 1) shows asymmetric infrascapular soft tissue density in the right chest wall.
Chest CT axial and coronal images (Fig 2, 3) show well-defined lenticular soft tissue density masses intermingled with fat strands in the subscapular areas of both chest walls between the ribs and serratus anterior muscles.
MR images (Fig 4-6) show heterogeneously iso- to high signal intensity masses on T1- and T2- weighted images with heterogeneous enhancement in both subscapular areas. No significant abnormal signal change was seen in the adjacent muscle or bone.
- Brief Review
- Elastofibroma dorsi is a benign fibroelastic lesion that is typically located in infrascapular areas between the ribs and serratus anterior, rhomboid major, and latissimus dorsi muscles. Unilateral masses have a slight right-sided predilection, but up to 60% of elastofibromas are bilateral. Elastofibroma dorsi is most frequently seen in older women, with a reported female predilection of 5~13:1.Mean age at diagnosis is 65-70 years. Most (>50%) elastofibromas dorsi are asymptomatic, but may cause mild to moderate pain. Symptomatic lesions are surgically excised and generally remain free of symptoms.
On CT, elastofibroma dorsi is typically a poorly defined, heterogeneous soft-tissue mass with attenuation similar to that of skeletal muscle, containing linear streaks of fat attenuation. However, it has also been reported to show homogeneous attenuation without visible internal foci of decreased attenuation.
On MRI, the lesion shows relatively low signal intensity (similar to muscle) on T1- and T2- weighted images. Internal fat within these hypointense lesions is seen as strands of T1 high signal intensity.
Therefore, on imaging, elastofibroma dorsi shows variable enhancement, reflecting the increased vascularity of the lesion.
- References
- 1. Naylor MF, Nascimento AG, Sherrick AD, McLeod RA. Elastofibroma dorsi: radiologic findings in 12 patients. AJR 1996;167:683-687.
2. Dinauer PA, Brixey CJ, Moncur JT, Fanburg-Smith JC, Murphey MD. Pathologic and MR Imaging Features of Benign Fibrous Soft-Tissue Tumors in Adults. RadioGraphics, 2007, 27;173-187.
3. Kransdorf MJ, Meis JM, Montgomery E. Elastofibroma: MR and CT appearance with radiologic-pathologic correlation, AJR 1992;159:575-579.
- Keywords
- Chest wall, Others,