Pleural Fibroma: MRI & CT

Woman 46 y/o with right hemithorax discomfort.
MR and CT prior to biopsy.

MRI
T1 low to intermediate signal and T2 low (due to high cellularity and collagen)
Intense enhancement with Gadolinium.
Necrotic areas, haemorrhagic, cystic components and myxoid degeneration can have high signal (T2).

CT
Soft-tissue mass applied to pleural surface
May have a lobulated contour
Avidly enhances but may have lower attenuation areas of necrosis or hemorrhage, especially in larger lesions
At least one angle with pleura is more often acute
May have small effusion
Calcification is rare
May have a pedicle that attached tumor to pleura
Malignant lesions are more often large and have necrosis.

Micro:
fibroblast-like cells with variable cellularity in collagenous, keloid-like stroma, reticulin fibers,hemangiopericytoma-like vessels. Rare mitotic activity, no atypia; entrapment of mesothelium at periphery. Focal myxoid change with bland spindle cells in myxoid vascularized stroma.

PLEURAL FIBROMA