Nodular fasciitis


Typical example of nodular fasciitis of the myxoid subtype.

Subcutaneous lesions tend to belong to a myxoid subtype and to be of younger age.

  • Ultrasound is helpful in determining whether the lesion is cystic or solid. The lesion can be of mixed echogenicity and sometimes the lesion presents as a low-level vascular lesion on doppler ultrasound despite the intense neovascularity visible on angiography
  • On MRI the myxoid subtypes show
    • homogeneous SI comparable with normal muscle on T1
    • high SI on fat saturation proton-density or T2 weighted images
    • they usually show mild to moderate enhancement, which is diffuse but slightly inhomogeneous
  • The increased T2 SI is most likely caused by fluid-filled mucoid spaces. Compact cellularity with a prominent capillary network and a myxoid pattern may be responsible for the enhancement on MRI.