Clinical History
Pailess mobile tumefation of ligneous consistence in the left leg.
Imaging Findings
Patient two years ago noted the presence of a painless tumefation in the left ankle which had increased in size very fast until, at the time of the admitting to our hospital, the lesion was estended caudally along the lateral face of the coscia. ItÍs consistence was ligneous, was mobile
to the superficial planes and more fixed to the deeper tissues.
Discussion
Nodular fasciitis is a being soft-tisse lesion due to proliferating fibroblasts; the lesion is
described as subcutaneous pseudosarcomatous fibromatosis
showing an alarming nodular proliferation of
fibroblasts .
Clinically most patients present a rapidly enlargy, palpable
soft-tissue mass.
This pathology is most frequently localized in the upper extremities (48%) in the trunk (20%) in head and neck (17%) and lower extremities (15%).According to anatomic localization we can distinguish 3 subtgypes: subcutaneous , intramuscolar and fascial which spreads along superficial fasciale planes .
Histologically the lesion is predominantly composed of
immature fibroblasts with little difference in size and
shape. The fibroblasts are arranged in characteristic short
irregular buldle and fascicles. There is a rich mixoid
matrix present early; older lesion had a fibrous histology .
The diagnosis of nodular fasciitis is founded on hystology.
It may be confused clinically and histologically with
aggressive fibromatosis and fibrosarcoma but on the basis
of morphology of cells, their organization into fascicles
the evidence of mucopolisaccaride matrix and vascularization
allow a definitive diagnosis.
Differential Diagnosis List