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Eur J Radiol. 2018 Sep;106:92-99. doi: 10.1016/j.ejrad.2018.07.020. Epub 2018 Jul 21.

Pilomatricoma (calcifying epithelioma): MDCT and MR imaging findings in 31 patients with radiological-pathological correlation.

Author information

1
Deptartment of Radiology, Institute of Surgery Research and Third Affilated Hospital, Army Medical University, Chongqing 400042, China. Electronic address: 1045471934@qq.com.
2
Department of Radiology, First Affilated Hospital, Army Medical University, Chongqing 400038, China. Electronic address: 258410723@qq.com.
3
Deptartment of Radiology, Institute of Surgery Research and Third Affilated Hospital, Army Medical University, Chongqing 400042, China. Electronic address: 248962499@qq.com.
4
Deptartment of Radiology, Institute of Surgery Research and Third Affilated Hospital, Army Medical University, Chongqing 400042, China. Electronic address: xiaxue_1104@163.com.
5
Department of Pathology, Institute of Surgery Research and Third Affilated Hospital, Army Medical University, Chongqing 400042, China. Electronic address: fightingzy@126.com.
6
Deptartment of Radiology, Institute of Surgery Research and Third Affilated Hospital, Army Medical University, Chongqing 400042, China. Electronic address: 909801791@qq.com.

Abstract

PURPOSE:

To describe the radiological characteristics of pilomatricomas on multi-detector computed tomography (MDCT) and magnetic resonance imaging (MRI), and to correlate the radiological findings and pathological features.

MATERIALS AND METHODS:

The radiological findings of 41 pilomatricomas in 31 patients were retrospectively reviewed. The images were evaluated with emphasis on calcifications, reticular and ring-like appearances, enhancement patterns, circular target sign and peritumoral fat stranding, and correlating these with pathological features.

RESULTS:

Of the 31 lesions evaluated by MDCT, 25(80.6%) showed different patterns of calcifications which included single in 12(38.7%) lesions and multiple in 13(41.9%) lesions, but peritumoral fat stranding was observed only in 2(6.5%) lesions. MRI scans were performed in 11 patients with 21 lesions, homogeneous and inhomogeneous hypointensities on T1-weighted (T1W) images were showed respectively in 14(66.7%) and 7(33.3%) lesions. On fat-suppressed (FS) T2-weighted (T2W) images, a ring-like hyperintensity was observed in all 21(100%) lesions, reticular hyperintensity, circular target sign, peritumoral fat stranding and secondary anetoderma were seen in 7(33.3%), 4(19%), 4(19%) and 1(4.8%) lesions, respectively; and a significant difference (P < 0.05) was found when comparing the maximum diameter of tumors with (2.3 ± 1.4 mm) and without (1.1 ± 0.3 mm) reticular hyperintensity. On contrast-enhanced T1W images, all 21(100%) lesions were found to have ring-like enhancement and 7(33.3%) of them showed reticular enhancement. The reticular and ring-like appearances on MR images respectively corresponded to the pathological edematous stroma and connective tissue capsule, and the four-layer structures of the circular target sign on FS T2W images also corresponded to pathological calcifications, shadow cells, epithelial cells and connective tissue capsule, respectively.

CONCLUSIONS:

The characteristic radiological findings associated with pilomatricomas include different patterns of calcifications on MDCT images and ring-like, reticular appearances and circular target sign on MR images. Radiological findings are well correlated with pathological nature.

KEYWORDS:

Calcifying epithelioma of Malherbe; Magnetic resonance imaging (MRI); Multi-detector computed tomography (MDCT); Pathology; Pilomatricoma

PMID:
30150057
DOI:
10.1016/j.ejrad.2018.07.020
[Indexed for MEDLINE]

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