Korean J Radiol.  2018 Aug;19(4):752-757. 10.3348/kjr.2018.19.4.752.

Ultrasonographic Findings of Subcutaneous Angioleiomyomas in the Extremities Based on Pathologic Subtypes

• Kim DG
• Lee SJ
• Choo HJ
• Kim SK
• Cha JG
• Park HJ
• Kwon JW
• Kim TE
• Jung SJ

• KMID: 2413704
• DOI: http://doi.org/10.3348/kjr.2018.19.4.752

Abstract

OBJECTIVE
The purpose of this study was to describe the ultrasonographic findings of angioleiomyoma based on pathological subtypes.
MATERIALS AND METHODS
Thirty-nine patients with subcutaneous angioleiomyomas in the extremities were retrospectively reviewed by two radiologists and a pathologist. Sonographic images were analyzed to evaluate each tumor's anatomic location, size, shape, margin, heterogeneity, echogenicity, associated findings, and vascularity.
RESULTS
Angioleiomyomas were divided into 3 subtypes: capillary (n = 16), venous (n = 22), and cavernous (n = 1). The one cavernous angioleiomyoma was a hypoechoic mass with rich vascularity. Hypoechogenicity was more frequently observed for venous tumors (77.3%) than for capillary tumors (43.8%), and isoechogenicity was more frequently observed for capillary tumors (56.2%) than for venous tumors (22.7%). Moderate vascularity was more frequently observed for venous tumors (59.1%) than for capillary tumors (12.5%), and little vascularity was more frequently observed for capillary tumors (62.5%) than for venous tumors (13.6%). The aforementioned findings including echogenicity (p = 0.034) and vascularity (p = 0.003) were statistically significant.
CONCLUSION
Awareness of sonographic findings of angioleiomyomas based on pathologic subtypes could be helpful for diagnosing angioleiomyoma and could increase diagnostic accuracy for superficial soft-tissue masses in our practice.

Keyword

Angioleiomyoma; Extremity; Ultrasonography; Pathologic correlation; Pathologic type

MeSH Terms

Angiomyoma*
Capillaries
Extremities*
Humans
Population Characteristics
Retrospective Studies
Ultrasonography

Figure

• 

  Fig. 1 35-year-old female with palpable mass that was confirmed to be cavernous angioleiomyoma in 1st web space of left hand.A. Gray-scale sonogram in longitudinal plane shows well-defined, homogeneously hypoechoic mass. B. Color Doppler sonogram of same lesion shows abundant vascularity with several feeding vessels. C. Photomicrograph shows that this mass had dilated vascular channels with minimal smooth muscle that merged with surrounding smooth muscles (arrow) and was mixed with thick-walled vessels (arrow head), indicating that tumor was cavernous angioleiomyoma (original magnification, × 100, H&E).

• 

  Fig. 2 67-year-old female with palpable mass that was confirmed to be venous angioleiomyoma in 4th–5th palmar region of hand.A. Gray-scale sonogram in longitudinal plane shows well-defined, homogeneously hypoechoic mass. B. Color Doppler sonogram of same lesion shows moderate vascularity with several feeding vessels. C. Photomicrograph shows that this mass had vessels (arrows) with thick muscular walls that merged with smooth muscle bundles, indicating that tumor was venous angioleiomyoma (original magnification, × 100, H&E).

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  Fig. 3 53-year-old female with palpable mass that was confirmed to be capillary angioleiomyoma in left calf.A, B. Transverse scan of gray-scale and color Doppler sonogram show well-defined, homogeneously isoechoic mass with little vascularity and feeding vessel (arrow). C, D. Longitudinal scan of gray-scale and color Doppler sonogram show absence of vascularity in mass with linear feeding vessels (arrows). E. Numerous capillary-sized vessels (arrows) surrounded by closely packed smooth muscle bundles are visible, indicating that tumor was capillary angioleiomyoma (original magnification, × 100, H&E).

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