Leiomyosarcoma in the Nasopharynx: MR Imaging Findings
R. Kuoa,
J.K. Huanga,b,
K.S. Leec,
B.F. Chend and
F.S. Yanga
a Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan
b Taipei Medical University, Taipei, Taiwan
c Department of Otolaryngology Mackay Memorial Hospital, Taipei, Taiwan
d Depertment of Pathology, Mackay Memorial Hospital, Taipei, Taiwan
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Fig 1. MR images of a 23-year-old man with a mass in the nasopharynx.
A, Sagittal gadolinium-enhanced fat-suppressed T1-weighted MR image reveals a well-demarcated tumor arising from the posterior wall of nasopharynx (arrow) with downward extension to oropharynx and compressing the soft palate and uvula (arrowhead).
B, Coronal gadolinium-enhanced fat-suppressed T1-weighted MR image shows that the tumor is confined within the nasopharynx and oropharynx without involvement of sphenopalatine foramen and pterygopalatine fossa on either side.
C, Axial T1-weighted image shows intermediate signal intensity of the tumor with lateral displacement of adjacent longus capitis muscles bilaterally (arrows).
D, Axial T2-STIR image at the same level as in C shows high signal intensity of the tumor. An enlarged 1-cm lymph node is seen in the right lateral retropharyngeal space (arrow).
E, Axial gadolinium-enhanced fat-suppressed T1-weighted MR image at the same level as in C shows strong homogenous enhancement of the tumor.
F, Axial gadolinium-enhanced fat-suppressed T1-weighted MR image shows a normal mucosal pattern of the bilateral lateral pharyngeal recesses (arrows) without tumor involvement.
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Fig 2. Histopathology of the tumor.
A, Features of spindle cell sarcoma are present (H&E, original magnification x200).
B, The tumor cells are pleomorphic and have atypical mitoses (H&E, original magnification x400).
C, The tumor cells are strongly immunoreactive for desmin (Desmin, original magnification x400).
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