Başak GÜLPINAR, Mustafa Fatih ARSLAN, Nuray HALİLOĞLU

Deri Altı Kitlelerde Ultrasonografi Bulguları

Amaç: Günlük pratikte karşılaştığımız, yüzeysel yerleşimli, palpabl yumuşak doku kitlelerinin ultrasonografi (US) görüntüleme bulgularını araştırmak amaçlanmıştır. Gereç ve Yöntem: Bölümümüzde Ekim 2012-Mart 2018 tarihleri arasında, palpabl deri altı lezyon nedeniyle US yapılan 92 hasta retrospektif olarak değerlendirildi. Hastane arşiv sisteminden hastaların US raporları, mevcutsa patoloji raporları, klinik ve radyolojik takipleri araştırıldı. Lipom ve basit kistler “kesinlikle benign” olarak kabul edildi. Hipoekoik/heterojen, oval şekilli ve düzgün kenarlı, minimal kanlanma gösteren ya da avasküler solid lezyonlar “olasılıkla benign” olarak sınıflandırıldı. Düzensiz kontürlü ve/veya disorganize kanlanma gösteren, heterojen solid kitleler “şüpheli lezyon” olarak belirlendi. Primer malignitesi olan hastalarda düzensiz kontürlü heterojen kitleler “yüksek olasılıkla metastaz” olarak değerlendirildi. Bulgular: Hastaların %9’unda US ile herhangi bir lezyon saptanmadı. Kırk altı hasta lipom icin tipik US bulgularına sahipti. On altı hastada basit ya da komplike kistik lezyon mevcuttu. On dört hastada “olasılıkla benign” lezyon saptandı ve hepsinde histopatolojik sonuç benigndi. Dört hastada “şüpheli lezyon” vardı ve histopatolojik tanı ikisinde yağ nekrozu, birinde ruptür epidermal inklüzyon kisti ve birinde leiomyosarkom idi. Primer malignitesi olan üç hastada “yüksek olasılıkla metastaz” olarak değerlendirilen yüzeyel lezyonlar vardı ve hepsi patoloji ile doğrulandı. Bir hastada aksesuar meme dokusu saptandı. Sonuç: US yüzeysel kitleleri göstermede, iç yapılarını ortaya koymada ve basit/benign kitleleri tanımada oldukça başarılıdır. İleri inceleme, US bulgularının tanımlayıcı olmadığı ya da şüpheli olduğu lezyonlarda gereklidir.

Ultrasound Imaging Findings of Subcutaneous Masses

Objectives: We aimed to investigate ultrasonography (US) imaging findings of palpable superficial soft-tissue masses in routine practice.Materials and Methods: We retrospectively investigated 92 patients with palpable subcutaneous masses, who underwent US imaging in ourdepartment between October 2012 and March 2018. Patients’ electronic medical records were reviewed for US reports, pathology results if available,and clinical/radiological follow-up. Lipomas and simple cysts were considered as “absolutely benign”. Hypoechoic/heterogenous solid lesions withoval shape and smooth margins, with minimal or no vascularization were determined as “probably benign”. “Indetermined lesions” were defined asheterogeneous masses with irregular margins or disorganized vascularity. Heterogeneous lesions with irregular margins in patients with a primarymalignancy were considered as “highly suspicious for metastases”.Results: In 9% of the patients, no lesion was detected on US. Forty-Six patients showed typical US imaging findings of lipoma, 16 lesions were definedas simple or complex cystic masses. Fourteen lesions were classified as “probably benign” on US and all of them were benign on histopathologicalexamination. Four lesions were classified as “indeterminate” on US and histopathological diagnosis was fat necrosis in two lesions, rupturedepidermal inclusion cyst in one lesion, and leiomyosarcoma in one lesion.Three patients with a known primary malignancy had lesions suggesting malignant infiltration, and they were all confirmed on histopathologicalexamination. Accessory breast tissue was detected in one patient presenting with axillary palpable mass.Conclusion: US is useful in demonstrating the presence and the nature of a mass and can diagnose benign incomplex masses. Further investigationshould be considered when US findings are inconclusive.

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