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Review Question - QID 6352

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QID 6352 (Type "6352" in App Search)
A 28-year-old woman has left shoulder pain and a tender soft-tissue mass. Based on the MRI scan and biopsy specimens shown in Figures 74a through 74c, what is the most likely diagnosis?
  • A
  • B
  • C

Malignant fibrous histiocytoma

24%

110/451

Lymphoma

3%

12/451

Synovial sarcoma

29%

129/451

Schwannoma

30%

137/451

Neurofibroma

13%

60/451

  • A
  • B
  • C

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Schwannomas (neurilemomas) occur at all ages but are most frequently seen in persons between the ages of 20 and 50 years. MRI features of schwannomas are fairly nonspecific, but when they are associated with a large named nerve, the identification of a mass in continuity with that nerve is highly suggestive of a schwannoma. Most have a fairly homogeneous appearance with a high water content and often fusiform shape. Classically, the histology shows alternating Antoni A (dense spindle cell region) areas and Antoni B (loose myxoid tissue) areas. They also demonstrate uniform intense immunostaining with S-100 protein.

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