Plexiform neurofibroma
Presentation
The patient complains of dyspnea and the right chest wall mass lesion. He declines any underlying disease.
Patient Data
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A large mass is seen in the apex of the right hemithorax, extending both medially and laterally. The lesion widens intercostal spaces and seems to be extrapleural with a similar lesion outside the rib cage in the right axilla and thoracic wall. The lesion has a high and iso signal on T2 and T1 weighted images respectively. It did not shows diffusion restriction and has minimal enhancement on post-contrast images. On scrutinized reviewing of theT2 weighted images, the mass consists of some elongated cord-like components with target sign in some parts suggestive of plexiform neurofibroma.
The white arrows depict the target sign.
The photo of the pathology report is included, which is in favor of neurofibroma.
Case Discussion
The patient underwent a percutaneous biopsy in the other center and paraffin blocks referred to our center pathology ward for a second opinion. The first pathologist suggested a solitary fibrous tumor or neurofibroma. Our pathologist opinion was in favor of neurofibroma.