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Nodular and Proliferative Fasciitis
Eric Walker, MD, MHA, FACR, FACHE; Catherine C. Roberts, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Synonyms

          • Subcutaneous pseudosarcomatous fibromatosis/fasciitis, pseudotumorous fibroblastic proliferation
        • Definitions

          • Nodular fasciitis (NF): self-limiting mesenchymal neoplasm that usually occurs in subcutaneous tissue
            • More common than proliferative fasciitis (PF) and proliferative myositis
          • PF: mass-forming subcutaneous proliferation characterized by large ganglion-like cells and plump myofibroblastic/fibroblastic cell swell
          • Proliferative myositis has same cellular composition as PF but occurs within skeletal muscle

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Nuclear Medicine Findings

                    • Angiographic Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      Selected References

                                      1. Sápi Z et al: Nodular fasciitis: a comprehensive, time-correlated investigation of 17 cases. Mod Pathol. 34(12):2192-9, 2021
                                      2. Oliveira AM et al: Nodular fasciitis. In Fletcher CDM et al: World Health Organization Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 49-52, 2020
                                      3. Gan S et al: Proliferative myositis and nodular fasciitis: a retrospective study with clinicopathologic and radiologic correlation. Int J Clin Exp Pathol. 12(12):4319-28, 2019
                                      4. Kim JY et al: Nodular fasciitis mimicking soft tissue metastasis on 18F-FDG PET/CT during surveillance. Clin Nucl Med. 40(2):172-4, 2015
                                      5. Lee KJ et al: Sonographic features of superficial-type nodular fasciitis in the musculoskeletal system. J Ultrasound Med. 34(8):1465-71, 2015
                                      6. Lu L et al: Nodular fasciitis: a retrospective study of 272 cases from China with clinicopathologic and radiologic correlation. Ann Diagn Pathol. 19(3):180-5, 2015
                                      7. Scourtas A et al: Nodular fasciitis clinically presenting as a sarcoma. Diagn Cytopathol. 43(6):488-9, 2015
                                      8. Kransdorf MJ et al: Fibrous and fibrohistiocytic tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 232-40, 2014
                                      9. Walker EA et al: Magnetic resonance imaging of benign soft tissue neoplasms in adults. Radiol Clin North Am. 49(6):1197-217, vi, 2011
                                      10. Walker EA et al: Magnetic resonance imaging of soft-tissue masses. Semin Roentgenol. 45(4):277-97, 2010
                                      11. Tomita S et al: Nodular fasciitis: a sarcomatous impersonator. J Pediatr Surg. 44(5):e17-9, 2009
                                      12. Duncan SF et al: Resolution of nodular fasciitis in the upper arm. Radiol Case Rep. 1(1):17-20, 2006
                                      13. Nikolaidis P et al: Sonographic appearance of nodular fasciitis. J Ultrasound Med. 25(2):281-5, 2006
                                      14. Kato K et al: Rapid involution of proliferative fasciitis. Skeletal Radiol. 33(5):300-2, 2004
                                      15. Evans H et al: Nodular fasciitis. In Fletcher CDM et al: World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press. 48-9, 2002
                                      16. Evans H et al: Proliferative fasciitis. In Fletcher CDM et al: World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press. 50-1, 2002
                                      17. Wang XL et al: Nodular fasciitis: correlation of MRI findings and histopathology. Skeletal Radiol. 31(3):155-61, 2002
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Synonyms

                                              • Subcutaneous pseudosarcomatous fibromatosis/fasciitis, pseudotumorous fibroblastic proliferation
                                            • Definitions

                                              • Nodular fasciitis (NF): self-limiting mesenchymal neoplasm that usually occurs in subcutaneous tissue
                                                • More common than proliferative fasciitis (PF) and proliferative myositis
                                              • PF: mass-forming subcutaneous proliferation characterized by large ganglion-like cells and plump myofibroblastic/fibroblastic cell swell
                                              • Proliferative myositis has same cellular composition as PF but occurs within skeletal muscle

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • CT Findings

                                                  • MR Findings

                                                    • Ultrasonographic Findings

                                                      • Nuclear Medicine Findings

                                                        • Angiographic Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          Selected References

                                                                          1. Sápi Z et al: Nodular fasciitis: a comprehensive, time-correlated investigation of 17 cases. Mod Pathol. 34(12):2192-9, 2021
                                                                          2. Oliveira AM et al: Nodular fasciitis. In Fletcher CDM et al: World Health Organization Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 49-52, 2020
                                                                          3. Gan S et al: Proliferative myositis and nodular fasciitis: a retrospective study with clinicopathologic and radiologic correlation. Int J Clin Exp Pathol. 12(12):4319-28, 2019
                                                                          4. Kim JY et al: Nodular fasciitis mimicking soft tissue metastasis on 18F-FDG PET/CT during surveillance. Clin Nucl Med. 40(2):172-4, 2015
                                                                          5. Lee KJ et al: Sonographic features of superficial-type nodular fasciitis in the musculoskeletal system. J Ultrasound Med. 34(8):1465-71, 2015
                                                                          6. Lu L et al: Nodular fasciitis: a retrospective study of 272 cases from China with clinicopathologic and radiologic correlation. Ann Diagn Pathol. 19(3):180-5, 2015
                                                                          7. Scourtas A et al: Nodular fasciitis clinically presenting as a sarcoma. Diagn Cytopathol. 43(6):488-9, 2015
                                                                          8. Kransdorf MJ et al: Fibrous and fibrohistiocytic tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 232-40, 2014
                                                                          9. Walker EA et al: Magnetic resonance imaging of benign soft tissue neoplasms in adults. Radiol Clin North Am. 49(6):1197-217, vi, 2011
                                                                          10. Walker EA et al: Magnetic resonance imaging of soft-tissue masses. Semin Roentgenol. 45(4):277-97, 2010
                                                                          11. Tomita S et al: Nodular fasciitis: a sarcomatous impersonator. J Pediatr Surg. 44(5):e17-9, 2009
                                                                          12. Duncan SF et al: Resolution of nodular fasciitis in the upper arm. Radiol Case Rep. 1(1):17-20, 2006
                                                                          13. Nikolaidis P et al: Sonographic appearance of nodular fasciitis. J Ultrasound Med. 25(2):281-5, 2006
                                                                          14. Kato K et al: Rapid involution of proliferative fasciitis. Skeletal Radiol. 33(5):300-2, 2004
                                                                          15. Evans H et al: Nodular fasciitis. In Fletcher CDM et al: World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press. 48-9, 2002
                                                                          16. Evans H et al: Proliferative fasciitis. In Fletcher CDM et al: World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press. 50-1, 2002
                                                                          17. Wang XL et al: Nodular fasciitis: correlation of MRI findings and histopathology. Skeletal Radiol. 31(3):155-61, 2002