case_images: PMC10043165_01
case_images: Images and pathological findings of the muscle masses. The lesion in the left soleus muscle of P1 was found to be hypoechoic on ultrasound (A), hypermetabolic on PETCT (B), enhanced on axial enhanced T1WI-TES (C), and light-hyperintense on T2W-SPAIR (D). Several well-formed epithelioid granulomas centered by caseous necrosis were observed [(G), HE, bar = 50 mum]. The lesion in the right gastrocnemius muscle of P2 was identified via enhancement on axial enhanced T1WI-TES (E) and hyperintensity on T2W-SPAIR (F). Three Langerhans cells in granulomas were noticed in the sections [(H), HE, bar = 50 mum]. P, patient; PETCT, positron emission tomography-computed tomography; T1W-TSE, T1-weighted turbo spin echo; T2W-SPAIR, T2-weighted spectral presaturation attenuated inversion recovery.
case_images: fmed-10-1106412-g0001.jpg
case_images: PMC10043165_02_fmed-10-1106412-g0001.jpg
case_images: F1
case_images: The patient in case 2 also underwent musculoskeletal MRI examination, and the result showed similar lesions to case 1 in the soleus muscle and medial posterior part of the right tibia and fibula (Figures 1E, F). Granulomatous inflammation, mainly composed of epithelioid histiocytes and Langerhans giant cells, was observed under the microscope (Figure 1H).
case_images: PMC10043165_02
case_images: Images and pathological findings of the muscle masses. The lesion in the left soleus muscle of P1 was found to be hypoechoic on ultrasound (A), hypermetabolic on PETCT (B), enhanced on axial enhanced T1WI-TES (C), and light-hyperintense on T2W-SPAIR (D). Several well-formed epithelioid granulomas centered by caseous necrosis were observed [(G), HE, bar = 50 mum]. The lesion in the right gastrocnemius muscle of P2 was identified via enhancement on axial enhanced T1WI-TES (E) and hyperintensity on T2W-SPAIR (F). Three Langerhans cells in granulomas were noticed in the sections [(H), HE, bar = 50 mum]. P, patient; PETCT, positron emission tomography-computed tomography; T1W-TSE, T1-weighted turbo spin echo; T2W-SPAIR, T2-weighted spectral presaturation attenuated inversion recovery.
case_images: fmed-10-1106412-g0001.jpg
case_images: PMC10043165_02_fmed-10-1106412-g0001.jpg
case_images: F1
case_images: The patient in case 2 also underwent musculoskeletal MRI examination, and the result showed similar lesions to case 1 in the soleus muscle and medial posterior part of the right tibia and fibula (Figures 1E, F). Granulomatous inflammation, mainly composed of epithelioid histiocytes and Langerhans giant cells, was observed under the microscope (Figure 1H).