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MR imaging of cheek lesions of Kimura’s disease: Focusing on the signal abnormalities and the relationship with superficial musculoaponeurotic systems

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Modern Research in Inflammation 2013年第4期2卷 69-74页

作者： Ryutarou Ukisu Yuichiro Kawahara norihiro hashizume Tamio Kushihashi Yoshinori Yamada Yoshiyuki Kadokura Department of Otolaryngology Showa University Northern Yokohama Hospital Yokohama Japan Department of Radiology Showa University Northern Yokohama Hospital Yokohama Japan

Background and Purpose: Kimura’s Disease (KD) is a rare benign chronic eosinophlic inflammatory disorder, characterized by angiolymphoid proliferation with peripheral eosinophilia and elevated serum immunoglobulin E. Most lesions occur in the head and neck regions. To the best of our knowledge, the relationship between subcutaneous cheek lesion of KD and the surrounding structures including superficial musculoaponeurotic systems (SMAS) has never been reported. The purpose of this study was to describe MR imaging findings of cheek subcutaneous lesion of KD and adjacent SMAS. Materials and Methods: Seven cheek subcutaneous lesions of 5 patients histopathologically proved KD were evaluated. We retrospectively evaluated the MR imaging findings of subcutaneous lesions for signal intensity in each imaging sequence, the border of the lesions, and appearance of SMAS. Results: All cheek lesions were displacing normal fat tissue. These lesions showed ill-defined border (7/7), slightly high signal intensity on T1-weighted images (7/7), and intermediate (1/7) or high signal intensity (6/7) on T2-weighted images. Cheek lesions were enhanced by intravenous injection of gadolinium to signal intensity close to that of fat tissue (3/4), and in one case, the avid enhancement of the mass was seen (1/4). All lesions attached to the outer surface of SMAS, however, only one out of 7 lesions distributed below the SMAS without tearing of the layers. SMAS below the lesion showed high signal intensity on T2-weighted images in two lesions (2/7). Conclusion: KD should be included in the differential diagnosis when a cheek mass presents with non-specific signal intensities and irregular border, which attaches to but does not interrupt SMAS on MR imaging.

关键词： Kimura’s Disease SMAS (Superficial Musculoaponeurotic Systems) MRI

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Gigantic Nasal Fibroma: CT and MR Imaging Findings with Histopathological Correlation

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Open Journal of Medical Imaging 2013年第3期3卷 102-104页

作者： Ryutarou Ukisu Yuichiro Kawahara norihiro hashizume Ryuichiro Fukuhara Madoka Tonouchi Hiroki Takenaka Tamio Kushihashi Department of Radiology Showa University Northern Yokohama Hospital Yokohama Japan

A 79-year-old woman with gradually worsening left nasal obstruction, purulent rhinorrhea and severe headaches for 6 months admitted to the hospital. A gray-white and huge mass occupying the left nasal cavity was found in physical examination. CT revealed a soft-tissue-density mass in the left nasal cavity with erosion of adjacent bone structures. On T2-weighted MR images, the lesion showed homogenous extreme low signal intensity. The patient underwent successful surgical removal of huge sinonasal soft tissue mass measuring 50 × 45 × 40 mm. The final diagnosis of fibroma was made histologically. MR imaging studies showed characteristic signal intensities corresponding to histopathological components. To the best of our knowledge, this is the first report regarding the MR imaging findings of huge nasal fibroma in the English literature.

关键词： Fibroma Nasal Cavity CT MRI

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