Sonographic findings of ruptured epidermal inclusion cysts in superficial soft tissue: emphasis on shapes, pericystic changes, and pericystic vascularity.

OBJECTIVE: The purpose of this study was to retrospectively evaluate the sonographic findings of ruptured epidermal inclusion cysts in superficial soft tissue, with an emphasis on shapes, pericystic changes, and pericystic vascularity. METHODS: The cases of 61 patients with surgically confirmed epidermal inclusion cysts were reviewed, and 13 patients were found to have ruptured cysts. The Ethics Committees of our institutions did not require patient approval or informed patient consent for this retrospective study. We evaluated the shapes, sizes, locations, pericystic changes, and pericystic vascularity for the 13 cases. RESULTS: The shapes of the ruptured epidermal inclusion cysts were classified into 3 types: with lobulations (type I, 2 cases), with protrusions (type II, 8 cases), and with abscess pocket formations (type III, 3 cases). The mean long diameter of the cysts was 3 cm. Common sites of ruptured epidermal inclusion cysts were the plantar surface of the metatarsophalangeal joint (4 cases) and buttocks (3 cases). Pericystic changes were noted in all of the type II and III cysts. Increased vascularity on color Doppler sonography was prominent in 3 type II cysts and 3 type III cysts. Deep abscess formation was noted in the epidermal inclusion cysts, especially for the type III cysts. CONCLUSIONS: A ruptured epidermal inclusion cyst visualized by sonography had variable shapes; the sonographic findings can be useful for obtaining a correct diagnosis of a ruptured epidermal inclusion cyst.     

Soft tissue chondromyxoid fibroma of the foot: sonographic findings

Chondromyxoid fibroma is a rare benign bone tumor, which represents less than 1% of primary bone tumors. However, chondromyxoid fibroma developing in the soft tissue is extremely rare. We report the sonographic findings in a case of soft tissue chondromyxoid fibroma in the foot confirmed pathologically.     

Necrotizing fasciitis: early sonographic diagnosis

Necrotizing fasciitis is a rare, but potentially fatal bacterial infection of the soft tissues. Establishing the diagnosis at the early stages of the disease remains the greatest challenge. We report a case of necrotizing fasciitis involving the upper extremity. Sonography revealed subcutaneous emphysema spreading along the deep fascia, swelling, and increased echogenicity of the overlying fatty tissue with interlacing fluid collections. The patient responded well to early surgical debridement and parenteral antibiotics.     

Bilateral epidermoid cysts of the testis: sonographic and MRI findings

Epidermoid cysts of the testis are rare benign lesions, without malignant potential, that can be managed conservatively with cyst enucleation and testis-sparing surgery. Bilateral epidermoid cysts in the testes have been reported very infrequently. We report the sonographic and MRI findings in a patient who presented with a palpable nodule in only 1 testis, but in whom sonography showed bilateral lesions. On sonography, the cysts had an internal "onion-ring" structure; color Doppler signals were absent. On MRI, the cysts had a laminated appearance, with alternating low- and high-signal-intensity areas on T2-weighted images. These imaging findings and the negative results of laboratory tests for tumor markers suggested the correct diagnosis, and testis-sparing surgery could be performed.     

Soft tissue diffuse neurofibromas: sonographic findings.

OBJECTIVE: The purpose of this study was to describe the sonographic findings of soft tissue diffuse neurofibromas. METHODS: Seven soft tissue diffuse neurofibromas proven pathologically were retrospectively evaluated. Medical records and histologic examinations were reviewed, and sonograms were analyzed for the echogenicity, location, margin, and vascularity. RESULTS: All identified lesions were hyperechoic masses permeated by multiple interconnecting irregular hypoechoic tubular or nodular structures. All lesions were located in the subcutaneous fat zone, and all had poorly defined margins with adjacent normal subcutaneous fat. The margins between the lesions and the adjacent muscles were well defined in 5 and poorly defined in the other 2. The vascularity was extensive in 5 lesions and scarce in the other 2. CONCLUSIONS: Soft tissue diffuse neurofibromas have a characteristic sonographic appearance; therefore, sonography should be considered a useful tool in the initial screening of this disease.     

Soft tissue foreign bodies: A training manual for sonographic diagnosis and guided removal

Sonography provides excellent detection, localization, and characterization of soft-tissue foreign bodies. Ultrasound guided foreign body removal is a safe and highly successful minimally invasive procedure that facilitates effective treatment and avoidance of complications in patients with soft tissue foreign bodies. Focused laboratory training is critical to successful implementation of a sonographic foreign body management practice.     

Placental lakes on sonographic examination: correlation with obstetric outcome and pathologic findings

PURPOSE: The aim of this study was to compare pregnancy outcome and pathologic findings in cases of placental lake visualized on sonography in pregnancies without concurrent fetal or maternal disease. METHODS: Placental aspect was evaluated sonographically in 4,106 singleton pregnancies without maternal or fetal disease at between 15 and 34 weeks3 gestation. Fifty-nine cases presenting with placental lakes were followed through the end of pregnancy. Obstetric outcome was compared with that of cases with sonographically normal placental aspects (n=37). Macroscopic and microscopic examinations for pathology were also performed in a few cases in both groups. RESULTS: Placental lakes were present in 2.2% (92/4,106) of the cases. No statistically significant difference was observed in birth weight, gestational age at delivery, adverse obstetric outcome, and macroscopic or microscopic results between the control and study groups. CONCLUSION: Our findings do not seem to indicate an increase in the risk for an adverse pregnancy outcome in cases presenting with placental lakes.     

Color Doppler sonographic findings in penile fracture

We performed color Doppler sonographic examination on 4 patients, 3 of whom had preliminary diagnoses of penile fracture and 1 of whom had undergone an operation due to penile fracture a year previously. Color Doppler sonography helped evaluate the relationships between the hematoma and the vascular structures and aided in differential diagnosis of the vascular injuries that may accompany tunical rupture (or have similar clinical presentations) and Mondor's disease; thus, this method has a crucial role in choosing the treatment approach. Color Doppler sonography may also assist in the follow-up of patients after surgical or conservative treatment.     

Ultrasonographic findings of gonarthritis caused by toothpick: A case report

We report a rare case of a 5‐year‐old patient with a toothpick in the knee joint resulting in septic arthritis. The toothpick was detected in the joint by sonography and was confirmed at surgery. A wooden foreign body is an uncommon cause of arthritis. This case report is followed by a discussion of the value of sonography in the diagnosis of wooden foreign‐body arthritis. © 2013 Wiley Periodicals, Inc. J Clin Ultrasound 42 :379–381, 2014     

头颈部软组织血管瘤病理及MR征象分析

目的：探讨头颈部软组织血管瘤MR征象特点。材料与方法：回顾性分析6例经手术病理证实的头颈部软组织血管瘤MRI表现。并与病理对照分析。结果：形态学上，头颈部血管瘤可见指样突起，信号改变上，所有病例于T1WI、T2WI均为混杂信号，T1WI以等或稍高信号为主，内混有脂肪样高信号及斑点状，线条状低信号，T2WI及T2WI/SPIR以明亮高信号为主；增强扫描为明显不均匀强化，呈斑点状，条状或蚓状。结论：MR信号特点可反映软组织血管瘤的复杂病理组成成分，，头颈部软组织血管瘤的形态有一定特征，认识这些征象有助于正确诊断血管瘤，并对其累及范围作出正确判断，为临床手术方案的制定提供依据。     

Imaging findings in a case of epidermal inclusion cyst arising within the breast parenchyma

Epidermal inclusion cysts rarely occur in the breast, but when they do, the consequences can be severe. Here, we report the case of a 23-year-old woman who presented with a palpable mass in the right breast. The mass had persisted for 4 years and had been causing pain for 1 month at the time of the patient's presentation. We examined the mass by means of mammography and sonography. Sonographic examination revealed a well-circumscribed solid, avascular mass suggestive of an epidermal inclusion cyst. Excision was performed at the patient's request. Histopathologic examination of the mass after excision confirmed the diagnosis of epidermal inclusion cyst and its localization within the breast parenchyma. To our knowledge, reports on epidermal inclusion cysts within the breast parenchyma are rare.     

乳腺癌超声分型与病理分型关系的研究

目的探讨乳腺癌超声分型与病理组织学分型的关系及其临床意义。方法对207例术后病理证实为乳腺癌患者的术前彩色多普勒超声声像图进行分型并与病理分型对照,分析各型超声特点及其与病理诊断符合率。结果207例乳腺癌患者中超声发现局灶性病变203例,根据声像图表现分为5型:Ⅰ型(团块型)158例,病理为浸润性癌155例(98.1%),早期浸润性癌3例,超声与病理诊断符合率为98.1%(155/158);Ⅱ型(结节型)23例,病理为浸润性癌18例,早期浸润性癌4例和原位癌1例,超声与病理诊断符合20例(8.7%);Ⅲ型(导管型)12例,病理为浸润性导管癌8例,原位癌4例,超声与病理诊断符合6例(50%);Ⅰ型与Ⅱ型、Ⅱ型与Ⅲ型超声与病理诊断符合率比较差异有统计学意义(P<0.05);Ⅳ型(囊样型)4例,病理诊断为原位癌1例,浸润性导管癌3例,超声与病理诊断符合3例;Ⅴ型(弥漫型)6例,病理诊断早期浸润性癌1例,浸润性导管癌5例,超声与病理诊断符合4例。余4例超声未见局灶性病变未予分型。207例乳腺癌超声与术后病理符合率为90.8%(188/207)。超声对乳腺癌病灶内微小钙化灶显示率为39.1%(81/207),其中以导管型居多(6/12)。结论乳腺癌的超声分型与病理分型密切相关;导管型声像图为乳腺癌的不典型声像之一。微小钙化灶是超声诊断导管型乳腺癌的重要征象。     

Sonographic appearance of a soft-tissue gossypiboma in the forearm with pathologic correlation

We describe the sonographic, radiologic, and histopathologic appearances of a soft tissue gossypiboma in the forearm of an 81-year-old woman with a history of a radial fracture treated with an internal fixation surgery.     

Cranial sonographic findings in Joubert's syndrome

The striking clinical picture of periodic hyperpnea and apnea, hypotonia, ataxia, mental retardation, retinal dystrophy, and oculomotor abnormalities found in association with radiologic evidence of agenesis of the cerebellar vermis characterizes Joubert's syndrome. We describe the cranial sonographic findings in 2 children with Joubert's syndrome from 2 families. Two children in the first family and 6 children in the second family were affected by Joubert's syndrome. To our knowledge, cranial sonographic findings in this syndrome have not been described before. © 1999 John Wiley & Sons, Inc. J Clin Ultrasound 27:41–44, 1999.