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E4952. Cutaneous and Subcutaneous Neoplastic and Nonneoplastic Conditions at Imaging: What Radiologists Should Know
Authors
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Nikolas Brozovich;
Augusta University
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Thomas Estes;
Augusta University
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Manohar Roda;
Yale University
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Frank Miller;
Northwestern University
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Camila Vendrami;
Northwestern University
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Courtney Moreno-; ;
Emory University
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Pardeep Mittal;
Augusta University
Background
Superficial soft-tissue lesions encompass a wide spectrum of cutaneous, subcutaneous, and fascial pathology that is commonly encountered in clinical practice, whether presenting as symptomatic lesions or incidental findings. Imaging can often lead to a definitive diagnosis, avoiding unnecessary biopsies and follow up. Superficial soft-tissue lesions may be classified in one of the following general diagnostic categories: neoplastic, nonneoplastic, infectious/inflammatory or posttraumatic/iatrogenic.
Educational Goals / Teaching Points
Categorization of superficial soft tissue lesions based on cellular origin. Imaging characteristics of symptomatic and incidentally found cutaneous, subcutaneous, and fascial pathology. Systemic approach to help narrow the differential diagnosis for superficial soft-tissue lesions.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Neoplastic: squamous cell carcinoma, basal cell carcinoma, melanoma, Merkel cell carcinoma, extramammary Paget's disease, lipoma, lipoblastoma, liposarcoma, desmoid tumor, plantar fibromatosis, schwannoma, neurofibroma, malignant peripheral nerve sheath tumor, metastasis, and cutaneous lymphoma and leukemia. Nonneoplastic: lymph node, pilonidal cyst, epidermoid inclusion cyst, miliary osteoma cutis, calcinosis of chronic renal failure, calcinosis universalis, and vascular malformations. Infectious/Inflammatory: cellulitis, panniculitis, scleroderma, abscess, pilonidal sinus, keloid, hidradenitis suppurative, necrotizing fasciitis/Fournier's gangrene, endometriosis, subcutaneous rheumatoid nodule, and injection granuloma. Posttraumatic/iatrogenic: hematoma, seroma, Morel-Lavallée lesion, neuroma, and silicone injection.
Conclusion
Superficial soft-tissue lesions represent a wide spectrum of pathology, which can be diagnosed on multiple imaging modalities. Patient history and lesion location often is important for characterization and diagnosis. Cutaneous, subcutaneous, and fascial lesions can be categorized into neoplastic, nonneoplastic, infectious/Inflammatory, or posttraumatic/iatrogenic pathology to narrow the differential diagnosis.
