Beyond schwannomas and neurofibromas: a radiological and histopathological review of lesser-known benign lesions that arise in association with peripheral nerves.

Peripheral nerve sheath tumors comprise a significant percentage of both benign and malignant soft tissue tumors. The vast majority of these lesions are schwannomas and neurofibromas, which most radiologists are familiar with including the well-described multimodality imaging features. However, numerous additional often under-recognized benign entities associated with nerves exist. These rarer entities are becoming increasingly encountered with the proliferation of cross-sectional imaging, particularly magnetic resonance imaging (MRI). It is important for the radiologist to have a basic understanding of these entities as many have near-pathognomonic MR imaging features as well as specific clinical presentations that when interpreted in concert, often allows for a limited differential or single best diagnosis. The ability to provide a prospective, pre-intervention diagnosis based solely on imaging and clinical presentation is crucial as several of these entities are "do not touch" lesions, for which even a biopsy may have deleterious consequences. To our knowledge, the majority of these benign entities associated with nerves have only been described in scattered case reports or small case series. Therefore, the aim of this article is to provide a radiopathologic comprehensive review of these benign entities that arise in association with nerves with a focus on characteristic MRI features, unique histopathologic findings, and entity specific clinical exam findings/presentation.

Optimizing the Radiology Experience through Radiologist-Patient Interaction.

Objective The goal of this survey-based study is to explore patients' knowledge of and expectations for radiologists in the outpatient setting.  Materials and Methods A comprehensive survey was distributed to adult patients undergoing knee magnetic resonance imaging (MRI) over a one-year period from September 2015 through August 2016 at an urban, quaternary care academic medical center. Results The survey results demonstrate that only a subset of patients undergoing knee MRI at the institution during the survey period are aware of the role of the radiologist, which is a well-documented fact described in the literature. Approximately one-third of patients expected to meet the radiologist during their visit to the department of radiology to undergo a knee MRI. The vast majority of patients surveyed wanted to be able to contact the person who read their exam, but only one patient actually contacted the radiologist during the study period.  Conclusion While the vast majority of surveyed patients wanted to be able to contact the person who read their knee MRI, only one patient actually did reach out to the radiologist to discuss findings. However, six of 36 follow-up respondents reported that they had contacted the person "who interpreted/read your exam:" two in person, one by email, three by phone, and one by other. Survey results demonstrated that only a subset of patients correctly understood the role of the radiologist (46% in the 1st survey and 63% in the 2nd survey, which does not represent a statistically significant difference), which suggests that perhaps the patients did have a conversation with a member of the radiology department staff whom they believed was actually the radiologist. The fact that patients expressed a desire to communicate with the person reading their reports, but then did not take advantage of the opportunity to contact the radiologist, suggests that the issue is more complicated than just a lack of a pathway for communication between patients and radiologists. Perhaps the lack of a clear understanding of the role of the radiologist hinders patients from contacting radiologists, as they feel uncertain as to whom they are actually attempting to reach. Or perhaps patients are sufficiently reassured by having a means through which they could contact the radiologist and do not require the actual communication in order to feel comfortable. There remains a significant amount of work to be done in understanding the barriers in patient-radiologist communications.

Radiofrequency ablation of solitary eosinophilic granuloma of bone.

OBJECTIVE: This article about our initial clinical experience describes the novel application of radiofrequency ablation for the treatment of two cases of solitary eosinophilic granuloma of the bone. CONCLUSION: Technical success was achieved in both cases with a prompt clinical response and no treatment-related complications. To our knowledge, this is the first description of the application of radiofrequency ablation for the treatment of solitary eosinophilic granuloma of the bone.

Staging of bone tumors: a review with illustrative examples.

OBJECTIVE: The radiologist plays an important role in the workup and staging of bone tumors. The purpose of this article is to review that role and to discuss recent changes to the primary malignant bone tumor staging system developed by the American Joint Committee on Cancer. CONCLUSION: Knowledge of staging parameters for the diagnosis and management of bone tumors will help the radiologist to generate meaningful reports for the referring physician.

Endometriosis of the vastus lateralis muscle.

We report an unusual case of a woman who sought medical attention for a painful mass within her anterolateral left thigh. The patient's symptoms waxed and waned with her menses. Magnetic resonance imaging revealed a 3 cm mass isointense to muscle and surrounded by a rim of decreased signal intensity on T1-weighted images. T2-weighted images with fat saturation revealed a low signal intensity mass with a surrounding rind of high signal intensity edema. Based on its magnetic resonance imaging characteristics, the lesion was initially thought to represent the sequela of prior trauma or perhaps a small fibrous tumor. An excisional biopsy of the mass, however, revealed endometrial tissue, and a pathologic diagnosis of intramuscular endometriosis was rendered.