Bowl of grapes sign

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The bowl of grapes sign is a descriptive radiological term used in the context of synovial sarcoma, a malignant soft tissue tumor. [1] This sign refers to the appearance of multiple small, rounded, fluid-containing spaces within a soft tissue mass, which resemble a cluster of grapes. [2] These cystic spaces are typically attributed to hemorrhage, necrosis, or myxoid degeneration within the tumor, a common feature of synovial sarcoma.

Radiological features

The bowl of grapes sign is typically identified on magnetic resonance imaging and computed tomography, and occasionally on ultrasound. During ultrasound examination, mixed echogenicity is noted in synovial sarcoma, with hypoechoic or anechoic areas corresponding to the cystic regions.

The cystic spaces in synovial sarcoma appear hyperintense on T2-weighted images, reflecting fluid content. Solid tumor components often demonstrate heterogeneous enhancement after contrast administration. The mass may display a multilocular appearance with well-defined cystic and solid regions, contributing to the grape-like pattern. [3] [4]

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References

  1. Cho, EB; Lee, SK; Kim, JY; Kim, Y (5 October 2023). "Synovial Sarcoma in the Extremity: Diversity of Imaging Features for Diagnosis and Prognosis". Cancers. 15 (19): 4860. doi: 10.3390/cancers15194860 . PMC   10571652 . PMID   37835554.
  2. Murphey, Mark D.; Gibson, Michael S.; Jennings, Bryan T.; Crespo-Rodríguez, Ana M.; Fanburg-Smith, Julie; Gajewski, Donald A. (September 2006). "Imaging of Synovial Sarcoma with Radiologic-Pathologic Correlation". RadioGraphics. 26 (5): 1543–1565. doi:10.1148/rg.265065084. ISSN   0271-5333. PMID   16973781 . Retrieved 1 January 2025.
  3. Baheti, AD; Tirumani, SH; Sewatkar, R; Shinagare, AB; Hornick, JL; Ramaiya, NH; Jagannathan, JP (February 2015). "Imaging features of primary and metastatic extremity synovial sarcoma: a single institute experience of 78 patients". The British Journal of Radiology. 88 (1046): 20140608. doi:10.1259/bjr.20140608. PMC   4614246 . PMID   25431890.
  4. Wang, David Jueyu; Alwafi, Leena; Pritchett, Stephany Lynn; Wehrli, Bret Michael; Spouge, Alison Rosemary Isobel (1 August 2021). "The Imaging Spectrum of Synovial Sarcomas: A Pictorial Review From a Single-Centre Tertiary Referral Institution". Canadian Association of Radiologists Journal. 72 (3): 470–482. doi:10.1177/0846537119899284. ISSN   0846-5371. PMID   32067487 . Retrieved 1 January 2025.