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British Journal of Radiology (2003) 76, 570-573
© 2003 British Institute of Radiology
doi: 10.1259/bjr/61286585
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Idiopathic presacral retroperitoneal fibrosis: report of two cases

B K Park, MD, S H Kim, MD and M H Moon, MD

The Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, SNUMRC, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea



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  		Figure 1. A 38-year-old male with presacral retroperitoneal fibrosis (case 1). (a) Transrectal colour Doppler ultrasound in transverse plane shows a homogeneous, hypoechoic mass with irregular infiltration in the space between the rectum and sacrum (arrowheads). The mass does not reveal flow signal. (b) Contrast-enhanced CT in the level of sacrum shows a presacral soft tissue mass infiltrating into the perirectal space (arrowheads). The bladder wall is thickened posteriorly (black arrowheads). (c) Photomicrograph ( x 200: haematoxylin–eosin stain) shows proliferative fibroblasts with inflammatory infiltrate of lymphocytes, plasma cells and eosinophils.

 


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  		Figure 2. A 55-year-old female with presacral retroperitoneal fibrosis (case 2). (a) Retrograde pyelogram shows obstruction of right pelvic ureter with smooth tapering margin (arrows). (b) Contrast-enhanced CT shows a thick, irregular-margined, soft tissue mass (arrowheads) anterior to the sacrum without bony destruction. Left ureter is well opacified (arrow) but the right ureter is not demonstrable. (c) T2 weighted and (d) contrast-enhanced T1 weighted sagittal MR images show a crescent-shaped soft tissue plaque (arrowheads) along the anterior surface of the sacrum. The lesion shows intermediate signal intensity on T2 weighted image and homogeneous enhancement on contrast-enhanced T1 weighted image. Note a signal-void structure (arrow) within the lesion that probably represent an encased vessel.

 




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