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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleHEAD & NECK

Malignant Fibrous Histiocytoma of the Head and Neck: CT and MR Imaging Findings

S.-W. Park, H.-J. Kim, J.H. Lee and Y.-H. Ko
American Journal of Neuroradiology January 2009, 30 (1) 71-76; DOI: https://doi.org/10.3174/ajnr.A1317
S.-W. Park
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H.-J. Kim
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J.H. Lee
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Y.-H. Ko
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    Fig 1.

    Case 1. Inflammatory type of MFH of the maxillary sinus in a 65-year-old woman. Axial MR images show a large ill-defined mass in the right maxillary sinus, which causes destruction of the sinus walls, extending into the anterior cheek and retromaxillary fat. A and B, Compared with the adjacent muscle, the signal intensity of the mass is mixed isointense and slightly hypointense on the T1-weighted image (A) and mixed hyperintense, isointense, and hypointense on the T2-weighted image (B). C, On the contrast-enhanced T1-weighted image, there is moderate heterogeneous enhancement at the periphery of the mass with the central areas remaining unenhanced. Also note that the mass invades the nasolacrimal duct, which is enlarged and filled with fluid (arrow in B).

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    Fig 2.

    Case 7. MFH of the lateral cheek in a 57-year-old man. A, Precontrast axial CT scan shows a large ill-defined soft-tissue mass involving the left masticator space with extension to the skin. The mass is isoattenuated to the adjacent muscle and contains several coarse and irregular calcifications peripherally (arrows). Postcontrast CT scans demonstrated marked heterogeneous enhancement within the mass (data not shown). B, Compared with the cerebral cortex, the signal intensity of the mass is mixed isointense and hyperintense on the axial fat-suppressed T2-weighted MR image. T1-weighted images demonstrated homogeneous isointense signal intensity of the mass (data not shown). C, On the contrast-enhanced axial fat-suppressed T1-weighted MR image, there is marked heterogeneous enhancement within the mass. Also note the involvement of the zygoma by the mass (arrows).

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    Fig 3.

    Case 9. Myxoid type of MFH of the anterior cheek in a 39-year-old man. Axial MR images show a well-defined ovoid soft-tissue mass in the left anterior cheek. The mass causes erosion of the frontal process of the maxilla (arrows). A and B, Compared with the cerebral cortex, the signal intensity of the mass is slightly hypointense on the T1-weighted image (A) and markedly hyperintense on the T2-weighted image (B). C, Contrast-enhanced fat-suppressed T1-weighted image shows marked homogeneous enhancement throughout the mass.

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    Fig 4.

    Case 13. Storiform-pleomorphic type of MFH of the orbital roof secondary to fibrous dysplasia in a 45-year-old woman. A, Postcontrast axial CT scan with bone window setting shows a large ill-defined osteolytic lesion in the left orbital roof. The adjacent cranial bones demonstrate a diffuse ground-glass appearance, typical of fibrous dysplasia (asterisk). B and C, On the axial MR images, the lesion is seen as a large ill-defined mass extending to the anterior face. Compared with the adjacent muscle, the signal intensity of the mass is mixed isointense and hyperintense on the T2-weighted image (B). T1-weighted images demonstrated isointense signal intensity of the mass (data not shown). On the contrast-enhanced T1-weighted image (C), there is mild-to-moderate heterogeneous enhancement at the periphery of the mass with the central areas remaining unenhanced. The background bone with fibrous dysplasia is markedly hypointense on the T2-weighted image and enhances heterogeneously after administration of contrast material (asterisks).

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  • Summary of CT and MR imaging features of 13 patients with MFH of the head and neck*

    Patient No./Age(yr)/SexCT/MR ImageCenter/ExtentBDSize (cm)MarginDensity on Precontrast CTT1WIT2WIEnhancement Pattern/DegreeHistologic Subtype
    1/65/FNo/yesMaxillary sinus/nasal cavity, orbit, buccal space, anterior cheekYes5.5Ill-defined–Mixed isointense, hypointenseMixed isointense, hyperintense, hypointenseHeterogeneous/moderateInflammatory
    2/46/FYes/yesMaxillary sinus/buccal spaceYes4.0Ill-definedIsodenseMixed isointense, hyperintenseMixed isointense, hyperintense, hypointenseHeterogeneous/moderateInflammatory
    3/42/MYes/noNasal cavity/maxillary sinus, ethmoid sinus, buccal spaceYes5.0Ill-definedMixed isodense, slightly hypodense––Heterogeneous/mild to moderateMyxoid
    4/58/MYes/noMaxillary sinus/anterior cheekYes3.9Ill-definedMixed isodense, slightly hypodense––Heterogeneous/moderateStoriform-pleomorphic
    5/34/MYes/yesMaxillary sinus/nasal cavity, ethmoid sinus, orbit, buccal space, anterior cheekYes4.0Ill-definedIsodenseMixed isointense, hyperintense, hypointenseMixed hyperintense, isointense, hypointenseHeterogeneous/moderateStoriform-pleomorphic
    6/46/MYes/yesNasal cavity/nasopharynx, nasal septumYes4.1Ill-defined–IsointenseMixed isointense, hypointenseHeterogeneous/moderateStoriform-pleomorphic
    7/57/MYes/yesMasticator space/zygomatic archYes7.8Ill-definedIsodenseIsointenseMixed isointense and hyperintenseHeterogenous/marked–
    8/30/MYes/yesMasticator space/zygomatic arch, middle cranial base, middle cranial fossaYes5.8Ill-definedIsodenseMixed isointense and hyperintenseMixed isointense and hyperintenseHeterogeneous/moderate to markedStoriform-pleomorphic
    9/39/MYes/yesAnterior cheek/nasal cavity, frontal process of maxillaYes4.5Well-definedSlightly hypodenseSlightly hypointenseMarkedly hyperintenseHomogeneous/markedMyxoid
    10/24/MYes/noInfraparotid lateral neck/sternocleidomastoid muscle, parotid glandNo6.8Ill-defined–––Heterogeneous/mild to moderateMixed storiform-pleomorphic and myxoid
    11/60/MYes/noPoststyloid parapharyngeal space/prevertebral space/carotid arteryNo5.2Ill-defined–––Heterogeneous/mild to moderateStoriform-pleomorphic
    12/41/FNo/yesUpper anterior gingiva/maxillary alveolar boneYes2.5Well-defined–IsointenseHyperintenseHomogeneous/moderateStoriform-pleomorphic
    13/45/FYes/yesOrbital roof/orbit, facial soft tissueYes5.0Ill-definedHypodenseIsointenseMixed isointense and hyperintenseHeterogenous/mild to moderateStoriform-pleomorphic
    • Note:—BD indicates associated bone destruction; T1WI, T1-weighted imaging; T2WI, T2-weighted imaging; MFH, malignant fibrous histiocytoma.

    • * Size was denoted as greatest diameter; density of the lesion was compared with that of the adjacent muscle; signal intensity of the lesion was compared with that of the cerebral cortex.

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American Journal of Neuroradiology: 30 (1)
American Journal of Neuroradiology
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S.-W. Park, H.-J. Kim, J.H. Lee, Y.-H. Ko
Malignant Fibrous Histiocytoma of the Head and Neck: CT and MR Imaging Findings
American Journal of Neuroradiology Jan 2009, 30 (1) 71-76; DOI: 10.3174/ajnr.A1317

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Malignant Fibrous Histiocytoma of the Head and Neck: CT and MR Imaging Findings
S.-W. Park, H.-J. Kim, J.H. Lee, Y.-H. Ko
American Journal of Neuroradiology Jan 2009, 30 (1) 71-76; DOI: 10.3174/ajnr.A1317
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