From the archives of the AFIP: Imaging of musculoskeletal neurogenic tumors: Radiologic-pathologic correlation

Mark D. Murphey, W. Sean Smith, Stacy E. Smith, Mark J. Kransdorf, H. Thomas Temple

Research output: Contribution to journalArticle

362 Scopus citations

Abstract

Numerous neurogenic tumors can affect the musculoskeletal system, including traumatic neuroma, Morton neuroma, neural fibrolipoma, nerve sheath ganglion, neurilemoma, neurofibroma, and malignant peripheral nerve sheath tumors (PNSTs). The diagnosis of neurogenic tumors can be suggested from their imaging appearances, including lesion shape and intrinsic imaging characteristics. It is also important to establish lesion location along a typical nerve distribution (eg, plantar digital nerve in Morton neuroma, median nerve in neural fibrolipoma, large nerve trunk in benign and malignant PNSTs). Traumatic and Morton neuromas are commonly related to an amputation stump or are located in the intermetatarsal space, respectively. Neural fibrolipomas show fat interspersed between nerve fascicles and are often associated with macrodactyly. Nerve sheath ganglion has a cystic appearance and commonly occurs about the knee. Radiologic characteristics of neurilemoma, neurofibroma, and malignant PNST at computed tomography (CT), ultrasonography, and magnetic resonance imaging include fusiform shape, identification of entering and exiting nerve, low attenuation at CT, target sign, fascicular sign, split-fat sign, and associated muscle atrophy. Although differentiation of neurilemoma from neurofibroma and of benign from malignant PNST is problematic, recognition of the radiologic appearances of neurogenic tumors often allows prospective diagnosis and improves clinical management of patients.

Original languageEnglish (US)
Pages (from-to)1253-1280
Number of pages28
JournalRadiographics
Volume19
Issue number5
DOIs
StatePublished - Jan 1 1999

Keywords

  • Nervous system, neoplasms, 4.315, 4.325, 4.364
  • Neurofibromatosis, 4.1444, 4.1831
  • Neuroma, 4.315, 4.364

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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