Foreign body granulomas represent a tissue granulomatous reaction to retained foreign bodies.

Clinical presentation

Foreign body granulomas typically present as a tender mass .


Granulatmous reactions aim to either resorb organic (e.g. wood,) or sequester inorganic (e.g. metal, glass) foreign bodies. If the foreign body completely resorbed the granulomatous reaction ceases but if not a capsule forms around the foreign body with the immune reaction often becoming inactive. If there is damage to the capsule then the granulomatous reaction, and possibly symptoms, recurs .

Radiographic features

Lesion morphology can vary widely and depends on the material, size and location of the foreign body .


High frequency (>10 MHz) linear probe is useful :

  • foreign bodies typically appear echogenic with posterior acoustic shadowing
  • foreign body granuloma appears as a hypoechoic halo that can consist of hematoma, edema and/or granulation tissue

A long-standing foreign body granuloma will have a capsule with the following signal characteristics :

  • T1: low signal
  • T2: low signal
  • T1C+: linear enhancement

Practical points

  • foreign body granulomas have been misdiagnosed as soft tissue tumors when a foreign body is not seen or recognized
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